Brachini Gioia, Duranti Giulia, Meneghini Simona, La Torre Marco, Cianci Eleonora, Lapolla Pierfrancesco, Simonelli Luigi, Warschauer Emilio Gentile, Cirocchi Roberto, Mingoli Andrea, Cirillo Bruno
Department of Surgery, Sapienza University of Rome, 00185 Rome, Italy.
Salvator Mundi International Hospital, UPMC, University of Pittsburgh Medical College, 00152 Rome, Italy.
J Clin Med. 2025 May 29;14(11):3835. doi: 10.3390/jcm14113835.
The clinical significance of serum potassium levels at admission in patients with blunt hepatic trauma remains insufficiently defined. This study aimed to evaluate the prevalence and prognostic value of admission hypokalemia in this patient population. We conducted a retrospective analysis of 164 patients with radiologically confirmed blunt liver trauma admitted between 2016 and 2023. Preoperative, intraoperative, and postoperative data were collected to assess the association between serum potassium levels and trauma severity (AAST grade-American Association for the Surgery of Trauma, ISS-Injury Severity Score), in-hospital morbidity, mortality, and length of stay. Univariate and multivariate analyses were performed, including checks for normality and multicollinearity. Serum potassium levels showed a significant positive correlation with age ( = 0.0064), and an inverse correlation with liver injury severity (AAST grade; = 0.01). Lower potassium levels were associated with longer hospital stays ( = 0.0459) and higher morbidity ( = 0.022). In multivariate analysis, only age ( = 0.036) and AAST grade ( = 0.014) were independent predictors of serum potassium concentration. Potassium levels were not independently associated with mortality. Admission hypokalemia is a common finding in blunt liver trauma and correlates with injury severity and adverse clinical outcomes. Potassium concentration may serve as a readily available, low-cost biomarker for early risk stratification in these patients. Further prospective studies are warranted to confirm its prognostic utility.
钝性肝外伤患者入院时血清钾水平的临床意义仍未得到充分明确。本研究旨在评估该患者群体中入院时低钾血症的发生率及其预后价值。我们对2016年至2023年间收治的164例经影像学确诊为钝性肝外伤的患者进行了回顾性分析。收集术前、术中和术后数据，以评估血清钾水平与创伤严重程度（美国创伤外科协会分级-AAST分级、损伤严重度评分-ISS）、院内发病率、死亡率及住院时间之间的关联。进行了单因素和多因素分析，包括正态性和多重共线性检验。血清钾水平与年龄呈显著正相关（=0.0064），与肝损伤严重程度呈负相关（AAST分级；=0.01）。低钾水平与住院时间延长（=0.0459）及发病率升高（=0.022）相关。在多因素分析中，只有年龄（=0.036）和AAST分级（=0.014）是血清钾浓度的独立预测因素。钾水平与死亡率无独立关联。入院时低钾血症在钝性肝外伤中常见，且与损伤严重程度及不良临床结局相关。钾浓度可作为这些患者早期风险分层的一种现成、低成本的生物标志物。有必要进行进一步的前瞻性研究以证实其预后效用。
