SO011HYPOPOTASSEMIA IN ELDERLY PATIENTS

Abstract

Introduction and Aims: Electrolyte imbalance is a common problem affecting the elderly. Total potassium store of elderly is reduced in comparison to young people (2500 vs 3000 mmol) due to 15% loss of muscle mass. This is more apparent in elderly females then males. Also, increased number of comorbidities and frequent use of drugs that may cause hypokalemia may increase the risk of hypokalemia in elderly. The aim of this study is to investigate the risk factors (sex, comorbidities, drugs), prognosis, related factors and rate of mortality and length of hospital stay in elderly patients who admitted to our hospital with hypokalemia. Methods: Patients (aged>65 years) who admitted to our hospital between 30.06.2014-29.06.2015 were screened. Among these patients ones with hypokalemia (potassium≤3.5 mEq/L) were investigated. Patients were divided into 2 groups according to the sex (Group 1: 119 male, group 2: 150 female). Control group consists of patients with potassium level 3.5-5.5 mEq/L (182 patients). Drugs which may cause hypokalemia, presence of comorbidities, hospital cost and clinical outcomes were investigated. Results: 36361 patients aged above 65 years were screened. Prevelance of hypokalemia was found 3.24% (1180/36361). 269 patients who fulfilled criteria were included. Group 2 patients used hydrochlorothiazide more than group 1 and comorbidity number of group 2 patients was significantly higher than group 1 (p<0.05). Mortality rate, need of intensive care and mechanical ventilation and the hospital cost were found higher in elderly females then males (p<0.05). [Length of hospital stay in group 1 and 2 (days): 6 (5-7), 8 (6-9), Cost (US Dollar): 533 (233-1166), 1100 (500-1600), respectively] (p<0.05). Median potassium value of the patients who died was 2.9 mEq/L, whereas it was 3.2 mEq/L for the patients who recovered (p<0.05). There was significant association between clinical outcome and potassium value. Neither sex nor age was found as a risk factor for hypopotassemia. Use of hydrochlorothiazide's (p: 0.024, 95% CI: 3.164-224.354), loop diuretics (p: 0.003, 95% CI: 4.364-214.558) and presence of ≥2 comorbid disease (p: 0.001, 95% CI: 15.873-2.964) were the risk factors for hypokalemia. Conclusions: Elderly females are on more risk for hypokalemia than elderly males. It is related to the presence of more comorbidities and more use of drugs leading hypokalemia in elderly females rather than sex difference. This increases the risk of mortality, need of intensive care and mechanical ventilation in elderly females, and the hospital cost. Attention should be paid when prescribing drugs that may cause hypokalemia and these patients should be followed closely.