West China School of Nursing, Sichuan University, Chengdu 610041, China.
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Dec 1;42(6):778-786. doi: 10.7518/hxkq.2024.2024130.
This study aimed to explore the risk factors of postoperative hypokalemia in patients with oral cancer and to provide a basis for preventing and controlling postoperative hypokalemia.
We included 366 patients undergoing oral cancer surgery in the Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University from January 2022 to August 2022. Univariate and multivariate analyses were used to determine the risk factors of postoperative hypokalemia. The receiver operation characteristic (ROC) curve was used to quantify the effectiveness of the factors. A nomogram of the risk factors for postoperative hypokalemia in oral cancer patients was developed and validated.
A total of 224 patients (61.20%) had postoperative hypokalemia, the lowest serum potassium level (3.50±0.35) mmol/L on the 4th day after surgery, and the highest incidence of hypokalemia (54.68%). Variables with <0.05 in the univariate analysis were quantified by ROC curve followed by multivariate logistic regression analysis. Results showed an independent correlation with postoperative hypokalemia as follows: preoperative serum potassium<3.87 mmol/L (=0.008), preoperative serum calcium<2.31 mmol/L (=0.033), preoperative PNI<49.16 (=0.032), postoperative drainage volume>264.25 mL (=0.002). The above variables were constructed into a postoperative hypokalemia risk nomogram and verified, and a good degree of fit was found.
The independent risk factors for postoperative hypokalemia in patients with oral cancer were as follows: preoperative serum potassium<3.87 mmol/L, preoperative serum calcium<2.31 mmol/L, preoperative PNI<49.16, and postoperative drainage volume>264.25 mL. Clinical attention should be paid to managing the above high-risk patients. Preventive potassium supplementation should be performed as soon as possible to reduce hypokalemia occurrence.
本研究旨在探讨口腔癌患者术后低钾血症的危险因素，为预防和控制术后低钾血症提供依据。
回顾性分析 2022 年 1 月至 8 月在四川大学华西口腔医院头颈肿瘤外科行口腔癌手术的 366 例患者的临床资料。采用单因素和多因素分析确定术后低钾血症的危险因素。采用受试者工作特征（ROC）曲线量化因素的有效性。建立并验证口腔癌患者术后低钾血症危险因素的列线图。
共 224 例（61.20%）患者发生术后低钾血症，术后第 4 天血钾最低（3.50±0.35）mmol/L，低钾血症发生率最高（54.68%）。单因素分析中<0.05 的变量经 ROC 曲线量化后行多因素 logistic 回归分析。结果显示与术后低钾血症独立相关的因素如下：术前血钾<3.87 mmol/L（=0.008）、术前血钙<2.31 mmol/L（=0.033）、术前 PNI<49.16（=0.032）、术后引流量>264.25 mL（=0.002）。将上述变量构建成术后低钾血症风险列线图并进行验证，发现拟合度较好。
口腔癌患者术后低钾血症的独立危险因素为：术前血钾<3.87 mmol/L、术前血钙<2.31 mmol/L、术前 PNI<49.16、术后引流量>264.25 mL。临床应注意对上述高危患者进行管理。应尽早进行预防性补钾，以减少低钾血症的发生。
