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首页> 外文期刊>Journal of critical care >Severe hyperkalemia can be detected immediately by quantitative electrocardiography and clinical history in patients with symptomatic or extreme bradycardia: A retrospective cross-sectional study
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Severe hyperkalemia can be detected immediately by quantitative electrocardiography and clinical history in patients with symptomatic or extreme bradycardia: A retrospective cross-sectional study

机译：症状或严重心动过缓患者可通过定量心电图和临床病史立即发现严重高钾血症：一项回顾性横断面研究

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Purpose: Detecting severe hyperkalemia is challenging. We explored its prevalence in symptomatic or extreme bradycardia and devised a diagnostic rule. Materials and Methods: This retrospective cross-sectional study included patients with symptomatic (heart rate [HR] ≤. 50/min with dyspnea, chest pain, altered mentality, dizziness/syncope/presyncope, general weakness, oliguria, or shock) or extreme (HR ≤. 40/min) bradycardia at an emergency department for 46 months. Risk factors for severe hyperkalemia were chosen by multiple logistic regression analysis from history (sex, age, comorbidities, and medications), vital signs, and electrocardiography (ECG; maximum precordial T-wave amplitude, PR, and QRS intervals). The derived diagnostic index was validated using bootstrapping method. Results: Among the 169 participants enrolled, 87 (51.5%) were female. The mean (SD) age was 71.2 (12.5) years. Thirty-six (21.3%) had severe hyperkalemia. The diagnostic summed "maximum precordial T ≥. 8.5 mV (2)," "atrial fibrillation/junctional bradycardia (1)," "HR ≤. 42/min (1)," "diltiazem medication (2)," and "diabetes mellitus (1)." The C-statistics were 0.86 (0.80-0.93) and were validated. For scores of 4 or higher, sensitivity was 0.50, specificity was 0.92, and positive likelihood ratio was 6.02. The "ECG-only index," which sums the 3 ECG findings, had a sensitivity of 0.50, specificity of 0.90, and likelihood ratio (+) of 5.10 for scores of 3 or higher. Conclusions: Severe hyperkalemia is prevalent in symptomatic or extreme bradycardia and detectable by quantitative electrocardiographic parameters and history.
机译：目的：检测严重的高钾血症具有挑战性。我们探讨了其在有症状或极端心动过缓中的流行程度，并设计了诊断规则。材料和方法：这项回顾性横断面研究包括有症状（极度呼吸困难，胸痛，心态改变，头晕/晕厥/晕厥，一般无力，少尿或休克）（症状或心率[HR]≤.50/ min）的患者（HR≤.40/ min）心动过缓在急诊室持续46个月。通过历史（性别，年龄，合并症和用药），生命体征和心电图（ECG;心前区最大T波振幅，PR和QRS间隔）的多元logistic回归分析选择严重高钾血症的危险因素。使用自举方法验证导出的诊断索引。结果：169名受试者中，有87名（51.5％）为女性。平均（SD）年龄为71.2（12.5）岁。三十六（21.3％）人患有严重的高钾血症。诊断总和为“最大心前区T≥。8.5 mV（2）”，“房颤/结节性心动过缓（1）”，“ HR≤.42/ min（1）”，“地尔硫卓药物（2）”和“糖尿病” （1）。” C统计量为0.86（0.80-0.93）并得到验证。对于4或更高的分数，敏感性为0.50，特异性为0.92，阳性可能性比为6.02。总计3个ECG结果的“仅ECG指数”的敏感性为0.50，特异性为0.90，对于3分或更高的得分，似然比（+）为5.10。结论：严重高钾血症普遍存在于症状性或极端性心动过缓，并可通过定量的心电图参数和病史进行检测。

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