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The Problems with Risk Prediction during an Emergency Medical Admission Using Laboratory Data - Evidence from
R Conway1, D Byrne1, S Cournane2
1Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
Background:
The prediction of clinical outcomes using biochemical markers is an important tool.
Methods:
We calculated a risk score for all emergency admissions 2002-2017. We related potassium and mortality in a multivariable fractional polynomial model. We investigated the potassium distribution and relationship of potassium to mortality over time.
Results:
There were 106,586 admissions in 54,928 patients. Mortality was higher for those with an admission potassium above the median - 6.1% vs 4.6% (p<0.001), OR 1.07 (95%CI: 1.06, 1.09). There was a progressive increase in mortality from the lowest - 8.9% (95%CI: 8.3%, 9.4%) to highest potassium decile - 14.2% (95%CI: 13.5%, 14.8%). The frequency of admission hypokalaemia and the mortality at any given potassium decreased over time.
Conclusion:
Admission potassium predicts mortality.
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