Clinical Prediction Model for Hypokalemia in Hospitalized Patients with Acute Decompensated Heart Failure Treated with Intravenous Furosemide
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Abstract
Background: Hospitalized patients with acute heart failure often receive furosemide, which may lead to hypokalemia. Factors such as diuretic dose and concomitant use of multiple diuretics are associated with this risk. This study aimed to develop a clinical prediction model for hypokalemia to help prevent its occurrence and related complications.
Methods: This is a retrospective clinical study of hospitalized patients with acute decompensated heart failure (ADHF). Using multivariable logistic regression, we derived a prediction score by assigning weights to the predictor coefficients. The score was then internally validated to assess its reliability.
Results: Among 510 hospitalized patients with ADHF receiving furosemide, 143 (28%) developed hypokalemia. Furosemide doses >1.5 mg/kg/day were strongly associated with hypokalemia (adjusted OR 4.81, 95% CI 2.56–9.04, p <0.001). Five predictors were identified: baseline serum potassium <4 mmol/L, serum albumin >3.5 g/dL, low serum magnesium, furosemide dose >1.5 mg/kg, and no prior spironolactone use. Higher scores were associated with an increased risk of hypokalemia.
Conclusions: The clinical prediction model provides a practical tool for estimating the risk of hypokalemia. ADHF
patients identified as high risk may benefit from preventive strategies and closer monitoring of potassium levels.
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