Impact of Hyperkalaemia on RAAS Inhibitor Use After Hospitalization
Author Information
Author(s): Ellis Hugh Logan, Al-Agil Mohammad, Kelly Philip A., Teo James, Sharpe Claire, Whyte Martin B.
Primary Institution: King’s College Hospital NHS Foundation Trust, London, UK
Hypothesis
RAASi withdrawal would be associated with worse mortality.
Conclusion
Cessation of RAASi was greater with hyperkalaemia and associated with increased mortality in hospitalised patients.
Supporting Evidence
- Hyperkalaemia prevalence was 8.57% in the emergency department and 16.79% among hospitalised patients.
- RAASi use was more common in hyperkalaemic patients, with higher discontinuation rates during hospitalisation.
- Discontinuation of RAASi was associated with 37% worse survival probability.
Takeaway
If patients with high potassium levels stop taking certain heart medications, they might not do as well after leaving the hospital.
Methodology
This was a retrospective cohort study of adult patients hospitalised from 1 January 2017 to 31 December 2020, using electronic health records to extract data.
Potential Biases
Potential bias due to reliance on electronic health records and the inability to assess illness severity.
Limitations
The study did not have access to primary care records to determine RAASi reinstatement rates after discharge.
Participant Demographics
{"total_patients":129172,"male_percentage":47.2,"female_percentage":52.8,"mean_age":50}
Statistical Information
P-Value
<0.001
Confidence Interval
95% CI for mortality risk associated with RAASi cessation was 1.370 (1.254–1.497)
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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