Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju, Chungcheongbuk-do, Republic of Korea.
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Emergency Medicine, College of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
Am J Emerg Med. 2021 Jul;45:86-91. doi: 10.1016/j.ajem.2021.02.024. Epub 2021 Feb 18.
We evaluated the relationship between hyperkalemia and wide QRS complex in patients with pulseless electrical activity (PEA) cardiac arrest.
This was a single-center, retrospective observational study of patients over the age of 18 treated for cardiac arrest at a tertiary referral hospital whose initial electrocardiogram rhythm was PEA from February 2010 to December 2019. Wide QRS PEA was defined as a QRS interval of 120 ms or more. Hyperkalemia was defined as serum potassium level > 5.5 mmol/L. The primary outcome was hyperkalemia. Multivariable logistic regression analysis was used to evaluate the relationship between wide QRS and hyperkalemia.
Among 617 patients, we analyzed 111 episodes in the wide QRS group and 506 episodes in the narrow QRS group. The potassium level in the wide QRS group was significantly higher than in the narrow QRS group (5.4 mmol/L, IQR 4.4-6.7 vs. 4.6 mmol/L, IQR 4.0-5.6, P < 0.001). Among all patients, 49.6% (n = 55/111) in the wide QRS group had hyperkalemia, which was significantly higher than the 26.7% (n = 135/506) in the narrow QRS group (P < 0.001). In multivariable logistic regression analysis, wide QRS PEA was significantly associated with hyperkalemia (odds ratio = 2.86, 95% confidence interval: 1.80-4.53, P < 0.001).
Wide QRS PEA as an initial cardiac rhythm was significantly associated with hyperkalemia in cardiac arrest patients.
评估在无脉性电活动（PEA）心搏骤停患者中，高钾血症与宽 QRS 波群之间的关系。
这是一项单中心、回顾性观察性研究，纳入 2010 年 2 月至 2019 年 12 月在一家三级转诊医院接受治疗的年龄在 18 岁以上的 PEA 心搏骤停患者，其初始心电图节律为 PEA。宽 QRS PEA 的定义为 QRS 间隔 120ms 或更长。高钾血症定义为血清钾水平>5.5mmol/L。主要结局是高钾血症。多变量逻辑回归分析用于评估宽 QRS 与高钾血症之间的关系。
在 617 例患者中，我们分析了宽 QRS 组的 111 个发作和窄 QRS 组的 506 个发作。宽 QRS 组的钾水平明显高于窄 QRS 组（5.4mmol/L，IQR 4.4-6.7 比 4.6mmol/L，IQR 4.0-5.6，P<0.001）。在所有患者中，宽 QRS 组 49.6%（n=55/111）发生高钾血症，明显高于窄 QRS 组的 26.7%（n=135/506）（P<0.001）。多变量逻辑回归分析显示，宽 QRS PEA 与高钾血症显著相关（比值比=2.86，95%置信区间：1.80-4.53，P<0.001）。
作为初始心脏节律的宽 QRS PEA 与心搏骤停患者的高钾血症显著相关。
