Follow-up of markedly elevated serum potassium results in the ambulatory setting: implications for patient safety.
Failure to follow up outpatient test results in a timely manner is a growing patient safety concern. To investigate the follow-up of markedly elevated serum potassium levels in the ambulatory setting, the authors reviewed the medical records of all patients seen in a large primary care practice between September 1, 2003, and August 31, 2004, with potassium levels > or = 5.8 mEq/L. Of the 12,914 serum potassium tests performed, there were 109 cases of markedly elevated serum potassium levels in 86 patients. The median potassium level was 5.9 mEq/L (range, 5.8-7.3). More than half the patients were recalled to the clinic specifically for repeat testing; however, 25% of patients had no repeat tests until they were seen at routine follow-up visits. The median time to a repeat potassium level was 6 days (range, 0-445). Patients > or = 65 years old had a lower likelihood of having repeat testing within 1 week (odds ratio = 0.38, P = .03).
Moore
Carlton R
CR
Division of General Internal Medicine, Mount Sinai School of Medicine, 1470 Madison Avenue, New York, NY 10029, USA. carlton.moore@mssm.edu
Lin
Jenny J
JJ
O'Connor
Nicky
N
Halm
Ethan A
EA
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D015331:Cohort Studies; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000032:analysis / Q000097:blood*; D012189:Retrospective Studies; D017751:Safety Management; D014481:United States
D011188:Potassium