Hyperkalaemia in Trauma

Published: 22 January 2024| Version 2 | DOI: 10.17632/2t8zv3b6k5.2
Michael Eichinger


This set includes retrospectively collected data from a Level-1 trauma centre in Austria. With these data, we conducted a retrospective cohort study on adult patients with traumatic bleeding admitted to a European Major Trauma Centre between January 2016 and December 2021. Patients were classified according to their serum potassium levels on arrival, and relevant clinical parameters between non-hyperkalaemic and hyperkalaemic patients were compared. Among the 83 patients in this study, 11 (13.3%) presented with hyperkalaemia on arrival. The median shock index showed a higher tendency in the hyperkalaemic group. Hyperkalaemia was found to be more prevalent among younger patients who sustained penetrating trauma. Mortality rates were higher in the hyperkalaemic group, but the difference was not statistically significant. Our results suggest that hyperkalaemia is prevalent in bleeding trauma patients on hospital arrival pre-transfusions, suggesting a more severe illness. Our findings provide insights into the pathophysiology and characteristics of hyperkalaemia in bleeding trauma patients. Further studies are required to investigate the mechanisms by which hyperkalaemia contributes to mortality in haemorrhagic shock patients.


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Adult trauma patients (age ≥18 years) who received at least five units of packed red blood cells (PRBCs) within the first 24 hours after admission were included in the study. Patients with an isolated traumatic brain injury (TBI) were excluded. Our primary aim was to evaluate the incidence and characteristics of patients in haemorrhagic shock with hyperkalaemia (>5.0 mmol/l) on hospital arrival before transfusions. The secondary aims were 1) to associate potassium with shock index as a parameter for physiologic decompensation and 2) to assess the effect of hyperkalaemia on 24-hour and 30-day mortality after admission in bleeding trauma patients. To compare characteristics between patients with potassium measurements ≤5.0 mmol/l and hyperkalaemic (>5.0 mmol/l) patient groups for independent variables, chi-squared or Mann-Whitney-U and Student's t-tests were used. Mortality was compared using chi-squared tests. Spearman's rank correlations were utilized to correlate vital parameters with Potassium. The JASP software package performed all statistical analyses, and statistical significance was set at p<0.05.


Bleeding, Trauma, Potassium