Geriatric Patients Are at a High Risk of Hypokalemia Associated with Yokukansan Preparation: A Retrospective Cohort Study
Geriatric Patients Are at a High Risk of Hypokalemia Associated with Yokukansan Preparation: A Retrospective Cohort Study
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DOI：
10.1248/bpb.b20-00476
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发表时间：
2020-11-01
影响因子：
2
通讯作者：
Itoh, Toshimasa
中科院分区：
文献类型：
--
作者：
Hirai, Toshinori;Yamaga, Ryosuke;Itoh, Toshimasa
虽然低钾血症是Yokukansan制剂的不良反应，尤其是在老年患者中，但其与年龄的关系尚不清楚。我们调查了年龄是否是低钾血症的危险因素。这项单中心回顾性队列研究于2015年6月至2019年5月在东京女子医科大学医学中心东进行，包括接受Yokukansan制剂的患者。主要结局为低钾血症（血清钾水平：< 3.0 mEq/L）。采用多变量考克斯比例风险模型确定风险因素、风险比（HR）和95%置信区间（95% CI）。还检查了截止年龄。在665例患者（中位年龄：78岁;四分位距：68-84岁）中，55例（8.3%）发生了与Yokukansan制剂相关的低钾血症。低钾血症的危险因素是年龄（HR：1.013，95% CI：1.006-1.021，p < 0.001），痴呆（HR：0.500，95% CI：0.357-0.682，p < 0.001），血清白蛋白水平（HR：0.754，95%CI：0.669-0.850，p < 0.001），和每日Yokukansan制剂剂量>= 7.5 g（HR：1.446，95%CI：1.144-1.850，p = 0.002）。截止年龄为>75岁和>80岁，而不是65岁和>70岁。临床医生应评估危险因素并监测血清钾水平，以避免与Yokukansan制剂相关的低钾血症。
Although hypokalemia is an adverse effect of Yokukansan preparation, especially in geriatric patients, its association with age is unclear. We investigated whether age is a risk factor for hypokalemia. This single-center retrospective cohort study, conducted at Tokyo Women's Medical University, Medical Center East between June 2015 and May 2019, included patients who received the Yokukansan preparation. The primary outcome was hypokalemia (serum potassium level: < 3.0 mEq/L). A multivariate Cox proportional hazard model was used to determine risk factors, hazard ratio (HR) and 95% confidence interval (95% CI). The cut-off age was also examined. Of 665 patients (median age: 78 years; interquartile range: 68-84 years), 55 (8.3%) developed hypokalemia associated with Yokukansan preparation. Risk factors for hypokalemia were age (HR: 1.013, 95% CI: 1.006-1.021, p < 0.001), dementia (HR: 0.500, 95% CI: 0.357-0.682, p < 0.001), serum albumin level ( HR: 0.754, 95% CI: 0.669-0.850, p < 0.001), and daily Yokukansan preparation dose >= 7.5 g (HR: 1.446, 95% CI: 1.144-1.850, p = 0.002). The cut-off ages were >75 and >80 years but not 65 years and >70 years. Clinicians should assess risk factors and monitor serum potassium levels to avoid hypokalemia associated with the Yokukansan preparation.