The incidence and risk factors of hypokalemia in hospitalized patients with heart failure

Abstract Background Potassium plays an important role in the occurrence and progression of heart failure patients,Hypokalemia is one of the most common electrolyte disorders in hospitalized patients with heart failure , which poses a significant threat to the prognosis of patients. Identifying risk factors for hypokalaemia is crucial.The primary aim of this study was to investigate the incidence and risk factors of hypokalemia in patients with heart failure within one week of admission, and to provide a reference for the prevention of hypokalemia. MethodsA total of 535 patients with heart failure who were hospitalized in the Department of Cardiovascular Medicine of the Affiliated Hospital of Zunyi Medical University from 2019 to 2022 were retrospectively selected by convenience sampling method, and were divided into hypokalemia group (160 cases) and non-hypokalemia group (375 cases) according to whether hypokalemia occurred within one week of admission.To select most relevant variables, the Least Absolute Shrinkage Selection Operator(LASSO) was applied, and then multivariate logistic regression analysis was further used to identify the risk factors of hypokalemia within one week of admission in patients with heart failure. Results Among the 535 patients with heart failure, 160 patients developed hypokalemia within one week of admission, with an incidence rate of 29.90%. The results of LASSO regression analysis showed that gender, peripheral edema, baseline serum potassium, calcium, albumin, prealbumin, and furosemide dose on the day of admission were the most correlated with hypokalemia within one week of admission. Multivariate Logistic regression analysis showed that female (OR: 2.171; 95%CI: 1.445~3.261), peripheral edema (OR: 1.692; 95%CI: 1.118~2.561), and furosemide dose on the day of admission (OR: 1.013; 95%CI: 1.005~1.021) were risk factors for hypokalemia within one week of admission, and the baseline serum potassium value was higher than that of normal low serum potassium (OR：0.355;95%CI: 0.217~0.581) was a protective factor for hypokalemia within one week of admission in patients with heart failure. Conclusion Even if the serum potassium is at a normal value at the time of admission, the incidence of hypokalemia in patients with heart failure is still high within one week of admission, and gender, peripheral edema, furosemide dose on the day of admission, and baseline serum potassium are closely related to the occurrence of hypokalemia.