Hyperkalemia in Combat Casualties: Implications for Delayed Evacuation

Military Medicine
Ian J StewartKevin K Chung

Abstract

Fixed facilities and rapid global evacuation ensured that delayed complications of trauma, such as hyperkalemia, occurred late in the evacuation chain where renal replacement therapies were available. However, future conflicts or humanitarian disasters may involve prolonged evacuation times. We sought to quantify one potential risk of delayed evacuation by assessing hyperkalemia in combat casualties. Retrospective study of military members admitted to intensive care units in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. This study was approved by the U.S. Army Medical Research and Materiel Command Institutional Review Board. Demographics, injury severity score, burn injury, mechanism of injury, vital signs, creatinine, and potassium were collected. Logistic regression models were used to identify incidence and risk factors for hyperkalemia. Of 6,011 patient records, 1,472 had sufficient data to be included for analysis. Hyperkalemia occurred in 5.8% of patients. Those with hyperkalemia had higher injury severity scores, higher shock index, were more likely to have acute kidney injury, and were more likely to die. On multivariate analysis, acute kidney injury and shock index were significantly associated with ...Continue Reading

Citations

Nov 15, 2018·Shock·Guillaume L HoareauIan J Stewart
May 7, 2019·Disaster Medicine and Public Health Preparedness·Kenneth D Lempert, Jeffrey B Kopp
Aug 28, 2020·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Gregor LindnerAdam J Singer
Aug 4, 2021·Journal of the American Society of Nephrology : JASN·Katsuyuki MatsushitaMichael P Hutchens

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