Wise Young
08-13-2002, 04:46 AM
• Beal AL, Scheltema KE, Beilman GJ and Deuser WE (2002). Hypokalemia following trauma. Shock. 18 (2): 107-10. Summary: Frequent hypokalemia was noted immediately after trauma, and it was hypothesized that hypokalemia occurred more frequently in the more severely injured. A retrospective trauma registry and chart review was done on 546 trauma patients looking at admission potassium, a variety of lab tests related to potassium, specific injuries, hospital/ICU lengths of stay, and general patient demographics. Admission hypokalemia (K < 3.6 meq/l) was more frequent in those with closed head injuries [41.1% vs. 27.5%, P < .001) and in those who suffered spinal cord injuries [54.5% vs. 33.6%, P < .05). Hyperglycemia was more frequent with admission hypokalemia [45.2% vs. 29.7%, P < .001). Hypokalemia occurred more frequently in younger patients [28.6 vs. 37.7 y, P < .001). Also, the pediatric group, ages 5-14, had admission hypokalemia more frequently than those ages 15-59, or those ages > 59 (54.9% vs. 34.5% vs. 16.7%, P < .001). Glasgow Coma Scores [GCS) were significantly lower [12.0 vs. 13.5, P < .001) and Injury Severity Scores [ISS) were higher [17.4 vs. 13.4, P < .001), with admission hypokalemia. Additionally, hypokalemia was a positive predictor of ISS [P = .05). Hypokalemic patients more likely needed a ventilator, [26.6% vs. 16.5%, P < .01) but did not have significantly more ventilator days [P > .05). Subsequently, hypokalemic patients had longer ICU lengths of stay (LOS) (2.6 vs. 1.5 days, P < .005) and longer hospital LOS [8.5 vs. 5.6 days, P < .001). When stratified into categories of "severe": [K < 3.1 meq/l), "moderate": [K = 3.1-3.3 meq/l), and "mild": [K = 3.4-3.5 meq/l) hypokalemia, those with severe hypokalemia had significantly lower GCS [10.0 vs. 13.1, p < .05), higher serum glucose levels [167 vs. 137 mg/dl, P < .05), lower creatinine levels [.77 vs. .95 mg/dl, P < .05), and longer hospital lengths of stay [13.1 days vs. 7.6 days, P < .05 results). <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12166770> North Memorial Health Care, Robbinsdale, Minnesota, 55422, USA.