The effect of admission serum potassium levels on in-hospital and long-term mortality in type A acute aortic dissection

摘要

Abstract Background Mild fluctuations in serum potassium (K + ) levels are related to the prognosis of cardiovascular disease. This study aimed to determine the effect of admission serum potassium levels on in-hospital and long-term mortality in patients with Stanford type A acute aortic dissection (AAD). Materials and methods A total of 588 consecutive patients with type A AAD were enrolled, and they were grouped according to admission serum potassium level: 3.5, 3.5 to 4.0, 4.0 to 4.5, 4.5 to 5.0, and ≥ 5.0 mmol/L. Clinical outcomes were in-hospital death and long-term all-cause mortality. Results The in-hospital and long-term all-cause mortality rates were 10.7% and 16.3%, respectively. A U-shaped relationship was observed between admission serum potassium levels and both in-hospital death and long-term mortality. Univariate Cox regression identified potassium levels outside the interval of 3.5 to 4.5 mmol/L to be a risk factor for both in-hospital and long-term death. After adjusting for age, gender, surgery and other risk factors, potassium levels outside the interval of 3.5 to 4.5 mmol/L still had a significant association with long-term death [hazard ratio (HR) = 1.72, 95% confidence interval (95% CI): 1.07–2.74, P = 0.024]. Surgical intervention was the main protective factor associated with both in-hospital (HR = 0.01, 95% CI 0.01–0.06, P 0.001) and long-term survival (HR = 0.06, 95% CI 0.03–0.12, P 0.001). Conclusions Among patients with Stanford type A AAD, admission serum potassium levels other than 3.5 to 4.5 mmol/L might be associated with an increased risk of in-hospital death and long-term mortality. Highlights ? Patients with type A AAD exhibited a U-shaped in-hospital and long-term mortality according to admission serum K + levels. ? In type A AAD, serum K + other than 3.5 to 4.5 mmol/L might be associated with increased risk of long-term death. ? The serum potassium level of 3.5 to 4.5 mmol/L might be optimal for emergency management of type A AAD. ? Surgical intervention was the main protective factor associated with both in-hospital and long-term survival. ]]>