Factors associated with time to follow-up of severe hyperkalemia in the ambulatory setting

Am J Med Qual. 2007 Nov-Dec;22(6):428-37. doi: 10.1177/1062860607305245.

Abstract

Background: Few studies have investigated the time it takes physicians to follow up abnormal outpatient laboratory results.

Methods: Medical record review of all adult patients seen at a primary care practice between January 2002 and December 2005 with serum potassium results > or = 6.0 mEq/L. We used a proportional hazards model to assess factors associated with time to follow-up for episodes of hyperkalemia.

Results: 259 of 48,333 serum potassium results met inclusion criteria. The median follow-up time was 3 days; after 30 days, 10% of cases had no follow-up. Residing in the same zip code as the clinic (HR = 1.39; P = .029), degree of hyperkalemia (HR = 2.97; P < .001), and renal insufficiency (HR = 1.41; P = .015) were associated with decreased time to repeat testing. Conversely, African Americans (HR = .51; P = .007) had increased time to repeat testing.

Conclusions: Follow-up of abnormal laboratory results in outpatients is suboptimal and research is needed to better understand factors that delay follow-up.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities*
  • Continuity of Patient Care*
  • Female
  • Humans
  • Hyperkalemia*
  • Male
  • Medical Audit
  • Middle Aged
  • New York City
  • Proportional Hazards Models
  • Severity of Illness Index*