Prognostic significance of hypokalemia in hepatic encephalopathy

The aim of this study was to investigate whether hypokalemia prognosticates outcomes in hepatic encephalopathy. We also examined other potential prognostic variables such as serum pH, systemic vascular resistance (SVR) and serum ammonia levels.

Patients with cirrhosis who were admitted for overt hepatic encephalopathy were included in the study and divided into two groups: Group-I consisted of patients with serum Potassium level < 4.0 mEq/L and Group-II consisted of patients with serum Potassium level > 4.0 mEq/L. We collected the baseline demographic data for both the groups including age, gender, ethnicity and calculated the Model for End Stage Liver Disease scores for both the groups at the time of admission. We analyzed the correlation between serum potassium levels and outcome variables including 30- day mortality rate, length of Intensive Care Unit (ICU)/ hospital stay, mechanical ventilation rate and 30-day readmission rate.

A total of 447 patients with diagnosis of cirrhosis were admitted to the hospital with overt hepatic encephalopathy between January 2008 and December 2012. 157 patients with low Potassium level (< 4.0 mEq/L) were included in Group-I while 290 patients with normal Potassium level (> 4.0 mEq/L) and were included in Group-II. Total length of stay in the hospital (P Value= 0.0001) and ICU length of stay (P Value= 0.0003) were significantly longer among the patients with serum potassium level of <4mEq/L.

We observed statistically significant correlation between serum potassium level and length of stay in hospital and ICU.