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血清钾离子变异性对 ICU 患者 28 天死亡率的影响。

The impact of serum potassium ion variability on 28-day mortality in ICU patients.

机构信息

Intensive Care Medicine Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Plastic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

出版信息

PLoS One. 2024 Nov 4;19(11):e0310046. doi: 10.1371/journal.pone.0310046. eCollection 2024.

Abstract

OBJECTIVE

Potassium ion disorders are prevalent among patients in Intensive Care Units (ICUs), yet there is a notable deficiency in established protocols and supplemental plans for potassium management. This retrospective study conducted at a single center aims to explore the relationship between potassium levels, their variability, and the 28-day mortality rate in ICU patients.

METHODS

This study analyzed data from patients admitted to the ICU of the First Affiliated Hospital of Guangxi Medical University between October 2022 and October 2023. We assessed serum potassium variability using the coefficient of variation and categorized it into four quartile groups (Q1, Q2, Q3, Q4). Additionally, patients were classified into six groups based on serum potassium concentrations. The associations between these categories and the 28-day mortality rate were evaluated using binary logistic regression, adjusting for potential confounders.

RESULTS

A total of 506 patients and 12,099 potassium measurements were analyzed. The group with the lowest potassium variability (Q1) exhibited the lowest mortality rate at 21% (P<0.01). It is noteworthy that within 28 days in the intensive care unit (ICU), the coefficient of variation (CV) of potassium levels significantly increased among deceased patients compared to surviving patients (P < 0.01).

CONCLUSION

Significant variability in potassium levels is associated with an increased risk of 28-day mortality among ICU patients, underscoring the need for stringent monitoring and management of potassium levels in this population.

摘要

目的

在重症监护病房(ICU)患者中,钾离子紊乱很常见,但在钾管理的既定方案和补充计划方面存在明显不足。本研究在广西医科大学第一附属医院的一家单中心进行,旨在探讨 ICU 患者的钾水平、钾水平的变异性与 28 天死亡率之间的关系。

方法

这项研究分析了 2022 年 10 月至 2023 年 10 月期间入住广西医科大学第一附属医院 ICU 的患者的数据。我们使用变异系数评估血清钾的变异性,并将其分为四个四分位组(Q1、Q2、Q3、Q4)。此外,根据血清钾浓度将患者分为六组。使用二元逻辑回归评估这些类别与 28 天死亡率之间的关联,并对潜在的混杂因素进行调整。

结果

共分析了 506 例患者和 12099 次钾测量值。钾变异性最低的组(Q1)的死亡率最低,为 21%(P<0.01)。值得注意的是,在 ICU 内的 28 天内,死亡患者的钾水平变异系数(CV)与存活患者相比显著增加(P < 0.01)。

结论

钾水平的显著变异性与 ICU 患者 28 天死亡率增加相关,这强调了在该人群中需要严格监测和管理钾水平。

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