Roberto Pecoits-Filho et al. Pedro Tulio Rocha Maristela Carvalho da Costa Pedro Schwartzmann … Lídia Ana Zytynski Moura Mauricio Longato Nicolas Segre Tamisa Rego Cinthia Montenegro Thyago Proença de Moraes
Abstract
Hyperkalemia is associated with poor prognosis in heart failure (HF), but its reporting in administrative data is likely suboptimal.
The aim was to evaluate the frequency and impact of hyperkalemia ICD coding during HF hospitalizations in Brazil.
We analyzed 3,551,738 HF hospitalizations from the DATASUS database (2008–2024). ICD codes were used to identify hyperkalemia. Logistic and Cox regression analyses assessed associations between comorbidities, outcomes, and resource utilization.
Only 491 hospitalizations (0.014%) were coded for hyperkalemia. These patients were older (mean 70.3 vs. 66.6 years) and had higher rates of chronic kidney disease, diabetes, and cardiovascular disease. Hyperkalemia was associated with increased in-hospital mortality (25% vs. 10%), ICU admissions (17% vs. 11%), dialysis (11% vs. 1%), and longer ICU stays (9.45 vs. 5.36 days). Average costs were 59% higher (2,402 vs. 1,512 BRL).
Hyperkalemia is severely underreported in Brazilian HF hospitalizations, despite being a clear marker of clinical severity and higher resource use. Improved awareness and coding may support better outcomes and planning.
