title: Hyperkalemia is Associated with Increased 30-Day Mortality in Hip Fracture Patients.
abstract: Abnormal plasma concentrations of potassium in the form of hyper- and hypokalemia are frequent among hospitalized patients and have been linked to poor outcomes. In this study, we examined the prevalence of hypo- and hyperkalemia in patients admitted with a fractured hip as well as the association with 30-day mortality in these patients. A total of 7293 hip fracture patients (aged 60 years or above) with admission plasma potassium measurements were included. Data on comorbidity, medication, and death was retrieved from national registries. The association between plasma potassium and mortality was examined using Cox proportional hazards models adjusted for age, sex, and comorbidities. The prevalence of hypo- and hyperkalemia on admission was 19.8% and 6.6%, respectively. The 30-day mortality rates were increased for patients with hyperkalemia (21.0%, p < 0.0001) compared to normokalemic patients (9.5%), whereas hypokalemia was not significantly associated with mortality. After adjustment for age, sex, and individual comorbidities, hyperkalemia was still associated with increased risk of death 30 days after admission (HR = 1.93 [1.55-2.40], p < 0.0001). After the same adjustments, hypokalemia remained non-associated with increased risk of 30-day mortality (HR = 1.06 [0.87-1.29], p = 0.6). Hyperkalemia, but not hypokalemia, at admission is associated with increased 30-day mortality after a hip fracture.
authors.affiliation: Department of Clinical Biochemistry, Hvidovre Hospital, University of Copenhagen, Kettegård Alle 30, 2650, Hvidovre, Denmark. debbie.agerskov@gmail.com.|Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark. debbie.agerskov@gmail.com.
authors.forename: Debbie
authors.identifier: 0000-0003-1025-6205
authors.initials: D
authors.lastname: Norring-Agerskov
authors.affiliation: Department of Clinical Biochemistry, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
authors.forename: Christian Medom
authors.initials: CM
authors.lastname: Madsen
authors.affiliation: Department of Medicine, Holbæk Sygehus, Smedelundsgade 60, 4300, Holbæk, Denmark.|Odense Patient Data Explorative Network, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Abrahamsen
authors.affiliation: DanTrials ApS, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Kbh NV, Denmark.
authors.forename: Troels
authors.initials: T
authors.lastname: Riis
authors.affiliation: Department of Clinical Immunology, Næstved Sygehus, Ringstedgade 61, 4700, Næstved, Denmark.
authors.forename: Ole B
authors.initials: OB
authors.lastname: Pedersen
authors.affiliation: Odense Patient Data Explorative Network, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense, Denmark.|Department of Clinical Biochemistry, Rigshospitalet Glostrup, University of Copenhagen, Nordre Ringvej 57, 2600, Glostrup, Denmark.
authors.forename: Niklas Rye
authors.initials: NR
authors.lastname: Jørgensen
authors.affiliation: Department of Clinical Biochemistry, Hvidovre Hospital, University of Copenhagen, Kettegård Alle 30, 2650, Hvidovre, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Bathum
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
authors.forename: Jes Bruun
authors.initials: JB
authors.lastname: Lauritzen
authors.affiliation: Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
authors.forename: Henrik L
authors.initials: HL
authors.lastname: Jørgensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000097:blood* / Q000150:complications / Q000401:mortality*; D006801:Humans; D006947:Hyperkalemia / Q000150:complications* / Q000401:mortality; D007008:Hypokalemia / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Hip fracture; Hyperkalemia; Hypokalemia; Mortality; Potassium