Analysis Group Study Fills Research Gap on Inpatient Management of Hyperkalemia and Subsequent Readmissions

Date:July 20, 2021
Location:Boston, MA

Analysis Group, a global leader in health economics and outcomes research (HEOR), published a real-world study of inpatient management of hyperkalemia and readmission to inpatient care. Hyperkalemia is a disorder characterized by elevated levels of serum potassium that is often caused by kidney disease. While hyperkalemia is commonly treated in an inpatient setting, there exists little recent real-world evidence on patient outcomes following hospitalization. Health care stakeholders need this information to assess treatment effectiveness and identify unmet needs.

The new study, which was published in the journal Hospital Practice, fills this gap by analyzing patient characteristics, inpatient clinical management, and post-discharge outcomes among patients in the US with mild, moderate, and severe hyperkalemia. A team of Analysis Group researchers – including Vice President Keith Betts and Managers Fan Mu and Erin Cook – found that while more than 80% of hyperkalemia patients’ serum potassium levels normalized during inpatient stay, recurrence and hospital readmission occurred frequently, and approximately one in six patients treated in an inpatient setting died.

The team of researchers conducted statistical analyses of relevant electronic medical records from the Research Action for Health Network (REACHnet) of 21,793 hyperkalemia patients between 2012 and 2018. Notably, the team found that:

  • 69% of patients had mild hyperkalemia during inpatient care, while 19% had moderate and 12% severe hyperkalemia.
  • The most common treatments during inpatient stay were temporizing agents such as calcium gluconate, insulin/dextrose, and sodium bicarbonate (mild: 29%; moderate: 46%; severe: 73%), as well as diuretics (33%; 37%; 35%).
  • Sodium polystyrene sulfonate (SPS) was commonly used, and was used more frequently as hyperkalemia severity increased (12%; 28%; 45%).
  • Inpatient treatment with novel potassium binders like patiromer was rare during the study period (<0.1% overall).
  • The potassium levels of 87% of patients normalized during inpatient stay.
  • The rate of hyperkalemia recurrence within 30 days of discharge was higher than expected for all categories (13%; 15%; 18%), which may indicate that long-term outcomes of episodic hyperkalemia management in the inpatient setting should be explored further.
  • A high rate of death among inpatient stays was observed (12%; 16%; 20%).
  • Almost no patients received a potassium binder at discharge, which may indicate a treatment path to explore.

The study, “Inpatient Management and Post-Discharge Outcomes of Hyperkalemia,” is published in the latest issue of Hospital Practice. Coauthors include Harold Szerlip of Baylor University Medical Center, Vivian Fonseca of Tulane University Medical Center, Gabriel Uwaifo of Oschner Medical Center, and Jill Davis and Rubeen Israni of AstraZeneca. Analysis Group Managing Principal Eric Wu provided study design support. Funding for the study was provided by AstraZeneca.

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About Analysis Group’s HEOR Practice

Founded in 1981, Analysis Group is one of the largest international economics consulting firms, with more than 1,000 professionals across 14 offices. Analysis Group’s health care experts apply analytical expertise to health economics and outcomes research, clinical research, drug safety, epidemiology, market access and commercial strategy, and health care policy. Analysis Group’s internal experts, together with its network of affiliated experts from academia, industry, and government, provide our clients with exceptional breadth and depth of expertise and end-to-end consulting services globally.