{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:41:19Z","timestamp":1791520879680,"version":"4.3.4"},"reference-count":30,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","award":["ESR-19-20263"],"award-info":[{"award-number":["ESR-19-20263"]}],"id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,5,5]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study the trends of hyperkalaemia in USA inpatient hospitalisation records with heart failure (HF), chronic kidney disease (CKD), acute kidney injury (AKI) and\/or type II diabetes mellitus (T2DM) from 2004 to 2014 with respect to prevalence and inpatient mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational cross-sectional and propensity score-matched case\u2013control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The National Inpatient Sample (representing up to 97% of inpatient hospital discharge records in the USA) from 2004 to 2014<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>120\u2009513\u2009483 (\u00b12 312 391) adult inpatient hospitalisation records with HF, CKD\/end-stage renal disease (ESRD), AKI and\/or T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Hyperkalaemia, defined as the presence of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code of \u2018276.7\u2019 in any of the first 15 diagnostic codes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The outcomes of interest are the annual rates of hyperkalaemia prevalence and inpatient mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 120\u2009513\u2009483 (\u00b12 312 391) adult inpatient hospitalisations with HF, CKD\/ESRD, AKI and\/or T2DM, we found a 28.9% relative increase of hyperkalaemia prevalence from 4.94% in 2004 to 6.37% in 2014 (p&lt;0.001). Hyperkalaemia was associated with an average of 4\u2009percentage points higher rate of inpatient mortality (1.71 post-matching, p&lt;0.0001). Inpatient mortality rates decreased from 11.49%\u00b10.17% to 6.43%\u00b10.08% and 9.67%\u00b10.13% to 5.05%\u00b10.07% for matched cases with and without hyperkalaemia, respectively (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hyperkalaemia prevalence increased over time and was associated with greater inpatient mortality, even after accounting for presentation characteristics. We detected a decreasing trend in inpatient mortality risk, regardless of hyperkalaemia presence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-059324","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T11:58:23Z","timestamp":1652961503000},"page":"e059324","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Inpatient hospitalisation and mortality rate trends from 2004 to 2014 in the USA: a propensity score-matched case\u2013control study of hyperkalaemia"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6732-8698","authenticated-orcid":false,"given":"Kristen Michelle","family":"Tecson","sequence":"first","affiliation":[{"name":"Baylor Heart and Vascular Institute, Baylor Scott & White Research Institute, Dallas, Texas, USA"},{"name":"Health Science Center, Texas A&M University College of Medicine, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca A","family":"Baker","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute, Baylor Scott & White Research Institute, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Clariday","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute, Baylor Scott & White Research Institute, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"McCullough","sequence":"additional","affiliation":[{"name":"Cardiorenal Society of America, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"2025121511551079000_12.5.e059324.1","unstructured":"Simon LV , Hashmi MF , Farrell MW . Hyperkalemia. Treasure Island, FL: StatPearls Publishing, 2020."},{"key":"2025121511551079000_12.5.e059324.2","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-014-0196-1"},{"key":"2025121511551079000_12.5.e059324.3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3909\/ricm0727","article-title":"Acute and chronic cardiovascular effects of hyperkalemia: new insights into prevention and clinical management","volume":"15","author":"McCullough","year":"2014","journal-title":"Rev Cardiovasc Med"},{"key":"2025121511551079000_12.5.e059324.4","first-page":"30317","article-title":"Prevalence and prognosis of hyperkalemia in patients with acute myocardial infarction","volume":"S0002-9343","author":"Grodzinsky","year":"2016","journal-title":"Am J Med"},{"key":"2025121511551079000_12.5.e059324.5","unstructured":"Mather M , Jacobsen LA , Pollard KM . Aging in the United States. Population Bulletin 2015;70 https:\/\/www.prb.org\/wp-content\/uploads\/2016\/01\/aging-us-population-bulletin-1.pdf"},{"key":"2025121511551079000_12.5.e059324.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.6458"},{"key":"2025121511551079000_12.5.e059324.7","doi-asserted-by":"publisher","DOI":"10.1159\/000485645"},{"key":"2025121511551079000_12.5.e059324.8","unstructured":"HCUP Database . Healthcare Cost and Utilization Project (HCUP). Available: https:\/\/www.hcup-us.ahrq.gov"},{"key":"2025121511551079000_12.5.e059324.9","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.117.003846"},{"key":"2025121511551079000_12.5.e059324.10","unstructured":"Houchens RL , Elixhauser A , Jiang J . Nationwide inpatient sample redesign final report. Rockville, MD: Agency for Healthcare Research and Quality, 2014."},{"key":"2025121511551079000_12.5.e059324.11","unstructured":"HCUP Methods Series . Healthcare cost and utilization project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality, 2016. www.hcup-us.ahrq.gov\/reports\/methods\/methods.jsp"},{"key":"2025121511551079000_12.5.e059324.12","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1390027."},{"key":"2025121511551079000_12.5.e059324.13","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/20009666.2019.1593778","article-title":"Influence of abnormal potassium levels on mortality among hospitalized heart failure patients in the US: data from national inpatient sample","volume":"9","author":"Basnet","year":"2019","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"2025121511551079000_12.5.e059324.14","doi-asserted-by":"crossref","first-page":"E1262","DOI":"10.1097\/BSD.0000000000000402","article-title":"Propensity-matched analysis of outcomes and hospital charges for anterior versus posterior cervical fusion for cervical spondylotic myelopathy","volume":"30","author":"Tanenbaum","year":"2017","journal-title":"Clin Spine Surg"},{"key":"2025121511551079000_12.5.e059324.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.04.041"},{"key":"2025121511551079000_12.5.e059324.16","doi-asserted-by":"publisher","DOI":"10.2307\/2683903"},{"key":"2025121511551079000_12.5.e059324.17","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1433141"},{"key":"2025121511551079000_12.5.e059324.18","first-page":"S48","article-title":"Electronic health records: then, now, and in the future","volume":"1","author":"Evans","year":"2016","journal-title":"Yearb Med Inform"},{"key":"2025121511551079000_12.5.e059324.19","first-page":"1141","article-title":"An integrated billing application to streamline clinician workflow","volume":"2014","author":"Vawdrey","year":"2014","journal-title":"AMIA Annu Symp Proc"},{"key":"2025121511551079000_12.5.e059324.20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.15441\/ceem.16.194","article-title":"A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes","volume":"4","author":"Singer","year":"2017","journal-title":"Clin Exp Emerg Med"},{"key":"2025121511551079000_12.5.e059324.21","first-page":"S44","article-title":"Management of hyperkalemic patients in the inpatient setting by hyperkalemia severity","volume":"25","author":"Davis","year":"2019","journal-title":"JMCP"},{"key":"2025121511551079000_12.5.e059324.22","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcx118"},{"key":"2025121511551079000_12.5.e059324.23","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1002\/ejhf.2134","article-title":"Serum potassium and outcomes in heart failure with preserved ejection fraction: a post-hoc analysis of the PARAGON-HF trial","volume":"23","author":"Ferreira","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2025121511551079000_12.5.e059324.24","unstructured":"NIDDK . Kidney disease statistics for the United States, 2016. Available: https:\/\/www.niddk.nih.gov\/health-information\/health-statistics\/kidney-disease [Accessed 16 Mar 2021]."},{"key":"2025121511551079000_12.5.e059324.25","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.3349\/ymj.2014.55.5.1348","article-title":"Evaluating the utility of rapid point-of-care potassium testing for the early identification of hyperkalemia in patients with chronic kidney disease in the emergency department","volume":"55","author":"You","year":"2014","journal-title":"Yonsei Med J"},{"key":"2025121511551079000_12.5.e059324.26","doi-asserted-by":"crossref","DOI":"10.3390\/nu10030261","article-title":"Dietary approach to recurrent or chronic hyperkalaemia in patients with decreased kidney function","volume":"10","author":"Cupisti","year":"2018","journal-title":"Nutrients"},{"key":"2025121511551079000_12.5.e059324.27","doi-asserted-by":"crossref","first-page":"140","DOI":"10.3909\/ricm0782","article-title":"Novel agents for the prevention and management of hyperkalemia","volume":"16","author":"McCullough","year":"2015","journal-title":"Rev Cardiovasc Med"},{"key":"2025121511551079000_12.5.e059324.28","doi-asserted-by":"publisher","DOI":"10.1097\/01.JAA.0000465221.04234.ca"},{"key":"2025121511551079000_12.5.e059324.29","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.mayocp.2019.05.019","article-title":"Potassium binders for hyperkalemia in chronic kidney Disease-Diet, renin-angiotensin-aldosterone system inhibitor therapy, and hemodialysis","volume":"95","author":"Palmer","year":"2020","journal-title":"Mayo Clin Proc"},{"key":"2025121511551079000_12.5.e059324.30","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3390\/pharmacy7040142","article-title":"Advancing pharmacist collaborative care within academic health systems","volume":"7","author":"Awdishu","year":"2019","journal-title":"Pharmacy"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-059324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:55:22Z","timestamp":1765828522000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-059324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,19]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/bmjopen-2021-059324"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-059324","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}