Hyperkalaemia predictor of death in chronic digoxin toxicity
- PDF / 123,387 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 98 Downloads / 148 Views
1
Hyperkalaemia predictor of death in chronic digoxin toxicity Hyperkalaemia correlates strongly with fatality in cases of chronic digoxin toxicity, despite appropriate treatment with anti-digoxin antibody Fab fragments (Fab), suggest study findings reported by US researchers. The researchers conducted a case-control study at a large urban medical centre affiliated with an urban regional Poison Control Center. Serum potassium levels were compared in patients (mean age 73 years) with chronic digoxin toxicity resulting in fatality (cases; n = 13) over a 7-year period (2000–2006) and survivors (controls; n = 13) over a 1-year period (2007–2008). Seven cases and five controls received appropriately dosed Fab. An elevated serum potassium level (≥ 5.0 mEq/L) before treatment with Fab was associated with a more than 36-fold increased risk of fatality (odds ratio 36.7; 95% CI 3.2, 412). Bradycardic ventricular response (< 60 ventricular beats/min) was also significantly associated with death, despite appropriate dosing with Fab (7.0; 1.1, 42.9). In six of seven (86%) deaths with appropriate dosing of Fab, the clinical presentation included both bradycardia and hyperkalaemia (p < 0.05). The researchers say that hyperkalaemia is a well known predictor of fatality in cases of acute digoxin toxicity, but to their knowledge this is the first study to correlate hyperkalaemia with fatality in cases of chronic digoxin toxicity. They recommend that therapy with Fab be mandatory in patients with chronic digoxin toxicity who present with hyperkalaemia, and that screening of potassium levels should not be limited to patients with acute digoxin toxicity. Manini AF, et al. Prognostic utility of serum potassium in chronic digoxin toxicity: a case-control study. American Journal of Cardiovascular Drugs 11: 173-178, No. 801159034 3, Jun 2011
0114-9954/10/1361-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 23 Jul 2011 No. 1361
Data Loading...
