High prevalence of hypokalemia after acute acetaminophen overdose: impact of psychiatric illness.
BACKGROUND
Hypokalemia is not an isolated disease but an associated finding in a number of different diseases. It is also a commonly neglected condition among patients with acute acetaminophen overdose.


OBJECTIVE
This study intended to determine the prevalence of hypokalemia and its clinical correlates in acute psychiatric illness among hypokalemic and normokalemic patients after acetaminophen overdose.


METHODS
This is a retrospective cohort study of hospital admissions for acute acetaminophen overdose conducted over a period of 5 years from 1 January 2004 to 31 December 2008. Demographic data and different types of psychiatric illness were compared between hypokalemic and normokalemic patients. Hypokalemia was predefined by a serum concentration <3.5 mmol/L. Statistical Package for Social Sciences (SPSS) 15 was used for data analysis.


RESULTS
Two hundred and eighty patients out of 305 admissions were studied. Hypokalemia was found in 63.6% of patients with a higher prevalence in the presence of psychiatric illness (67.7%). Hypokalemic patients were significantly associated with the presence of major depression (p = .04), adjustment disorder (p < .001), anxiety (p = .01), and suicidal attempts (p = .04).


CONCLUSIONS
Hypokalemia was common among patients with psychiatric illness and acute acetaminophen overdose.
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia, Penang, Malaysia. saedzyoud@najah.edu
Sa'ed H
SH
Zyoud
Rahmat
R
Awang
Syed Azhar
SA
Syed Sulaiman
Samah W
SW
Al-jabi
D000082:Acetaminophen / Q000506:poisoning*; D000275:Adjustment Disorders / Q000097:blood / Q000150:complications; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000097:blood / Q000150:complications; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000150:complications; D062787:Drug Overdose / Q000150:complications; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000517:prevention & control; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000150:complications*; D011188:Potassium / Q000008:administration & dosage / Q000097:blood; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013406:Suicide, Attempted; D055815:Young Adult
D000082:Acetaminophen; D011188:Potassium