Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 35286,
    "title": "Hyperkalemia or Not? A Diagnostic Pitfall in the Emergency Department",
    "subtitle": null,
    "abstract": "<p><strong>Introduction: </strong>Hyperkalemia, a potentially life-threatening electrolyte disturbance, is commonly encountered in the Emergency Department (ED). However, the frequency of factitious hyperkalemia, an artificially elevated potassium level in hyperkalemic ED patients, is unknown. This study aims to detect the rate of factitious hyperkalemia among patients with a potassium concentration of ≥5.0 mmol/l in an all-comer ED population.</p>\n<p><strong>Methods: </strong>This retrospective, monocentric chart review analyzed data of 2,440 ED patients who presented with a potassium concentration of ≥5.0 mmol/L in their initial whole blood or plasma sample, who also underwent a repeat potassium measurement on the same day. Two groups were established based on potassium levels in the initial and repeat blood tests: 1) True hyperkalemia, characterized by consistently elevated potassium levels in both the initial and repeat samples; and 2) Factitious hyperkalemia, defined by an elevated initial potassium level while the repeat blood test showed a normal potassium level. A subset of factitious hyperkalemia was spurious hyperkalemia. In spurious hyperkalemia, the initial blood sample showed an elevated potassium level with evidence of hemolysis, but a repeat test revealed a normal potassium level without evidence of hemolysis.</p>\n<p><strong>Results: </strong>Of the 2,440 patients, 1,576 (65%) had true hyperkalemia and 864 (35%) factitious hyperkalemia. Among the 864 patients with factitious hyperkalemia, 597 (69%) displayed hemolysis in their initial blood sample, indicating spurious hyperkalemia due to in-vitro hemolysis.</p>\n<p><strong>Conclusion: </strong>These data show that about one third of all hyperkalemic blood samples drawn in the ED were due to factitious hyperkalemia. The leading cause of factitious hyperkalemia was spurious hyperkalemia due to in-vitro hemolysis.</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [],
    "section": "Letters to the Editor",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/01m613gh",
    "frozenauthors": [
        {
            "first_name": "Frank-Peter",
            "middle_name": "",
            "last_name": "Stephan",
            "name_suffix": "",
            "institution": "Bürgerspital Solothurn, Department of Cardiology, Solothurn, Solothurn, Switzerland",
            "department": ""
        },
        {
            "first_name": "Florian",
            "middle_name": "N.",
            "last_name": "Riede",
            "name_suffix": "",
            "institution": "Kantonsspital Aarau, Department of Cardiology, Aarau, Aarau, Switzerland",
            "department": ""
        },
        {
            "first_name": "Luca",
            "middle_name": "",
            "last_name": "Ünlü",
            "name_suffix": "",
            "institution": "University Hospital Basel, Emergency Department, Basel, Basel Stadt, Switzerland; Karl Landsteiner University of Health Sciences, Krems an der Donau, Lower Austria, Austria",
            "department": ""
        },
        {
            "first_name": "Gioele",
            "middle_name": "",
            "last_name": "Capoferri",
            "name_suffix": "",
            "institution": "University Hospital Basel, Emergency Department, Basel, Basel Stadt, Switzerland",
            "department": ""
        },
        {
            "first_name": "Tito",
            "middle_name": "",
            "last_name": "Bosia",
            "name_suffix": "",
            "institution": "Le Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Lausanne, Switzerland",
            "department": ""
        },
        {
            "first_name": "Axel",
            "middle_name": "",
            "last_name": "Regeniter",
            "name_suffix": "",
            "institution": "MEDICA Medical Laboratories, Zürich, Zürich, Switzerland",
            "department": ""
        },
        {
            "first_name": "Roland",
            "middle_name": "",
            "last_name": "Bingisser",
            "name_suffix": "",
            "institution": "University Hospital Basel, Emergency Department, Basel, Basel Stadt, Switzerland",
            "department": ""
        },
        {
            "first_name": "Christian",
            "middle_name": "H.",
            "last_name": "Nickel",
            "name_suffix": "",
            "institution": "University Hospital Basel, Emergency Department, Basel, Basel Stadt, Switzerland",
            "department": ""
        }
    ],
    "date_submitted": "2024-09-06T00:33:48.639000Z",
    "date_accepted": "2024-09-16T19:57:20.471000Z",
    "date_published": "2024-11-27T14:00:00Z",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/westjem/article/35286/galley/30137/download/"
    },
    "galleys": [
        {
            "label": "Layout",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/35286/galley/29910/download/"
        },
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/35286/galley/30137/download/"
        }
    ]
}