Clinical Outcomes of Hospitalization for Severe Hyperkalemia in the Absence of Life-threatening Manifestations

This is the authors' abstract. We don't add key points for this paper.

Introduction: Severe hyperkalemia warrants immediate hospitalization for patients with acute instability. However, the benefit of inpatient care in the absence of acute instability remains poorly defined. We therefore evaluated clinical outcomes across clinical settings for these patients. Methods: ] ≥6.5 mEq/L). Among the initial cohort, our primary analysis focused on patients without life-threatening arrhythmias or other concurrent acute complications; the risk of 90-day all-cause mortality and hyperkalemia recurrence was compared between inpatient and outpatient management using overlap weighting. Results: elevation itself (99 inpatients and 275 outpatients), weighted logistic regression showed no significant difference in 90-day all-cause mortality between the two groups (odds ratio [OR] 1.39, 95% confidence interval [CI] 0.31-6.26); no hyperkalemia-specific deaths occurred. In contrast, outpatient management was associated with a significantly higher risk of hyperkalemia recurrence (OR 4.82, 95% CI 1.04-22.44). Conclusions: While outpatient management for severe hyperkalemia might be feasible for clinically stable patients in terms of short-term mortality, it carries a substantially increased risk of recurrence. Accordingly, hospitalization should generally be regarded as the preferred strategy.