Trauma patients with hypokalemia have an increased risk of morbidity and mortality

Introduction: The aims of our study were (1) to determine the prevalence of hypokalemia, (2) to evaluate predictors for hypokalemia, and (3) to show the influence of hypokalemia on in-hospital outcome (mortality, adverse events, and length of stay) in a general trauma cohort. Methods: We performed a four-year retrospective study and analyzed the influence of hypokalemia during hospitalization in all adult trauma patients admitted to a Level-1 trauma center. A total of 7692 consecutive trauma patients were included and further analyzed. We used multivariate regression analyses to examine the predictors for hypokalemia, mortality, adverse events, and length of stay while adjusting for covariates, including age, sex, injuries and comorbidities. Results: Hypokalemia was present in 33% (n = 2565) of all adult trauma patients, with a peak at the first two days. Congestive heart failure (OR 2.2, p < 0.001) and head injury (OR 2.0, p < 0.001) were the most important risk factors for hypokalemia. Moderate to severe hypokalemia (<3.0mmol/L) was a significant predictor for mortality (OR 2.4, p = 0.001), while mild hypokalemia (3.0 - 3.5mmol/L) was not. Moderate to severe hypokalemia (OR 3.4, p < 0.001) and mild hypokalemia (OR 1.7, p < 0.001) were significant predictors for adverse events. Last, patients with hypokalemia stayed significantly longer in the hospital (13 +/- 9 days vs. 8 +/- 12, p < 0.001). Conclusions: Trauma patients presenting with hypokalemia during hospitalization have an increased risk of dying and suffering adverse events and need special medical attention.