# Association between serum potassium levels and haematoma expansion in intracerebral hemorrhage: a retrospective cohort study

## TL;DR

Low serum potassium levels are linked to increased brain bleeding after strokes, suggesting potassium may influence stroke severity.

## Contribution

This study identifies a novel association between low serum potassium and haematoma expansion in intracerebral hemorrhage patients.

## Key findings

- After matching, HE patients had significantly lower potassium levels than non-HE patients.
- Low potassium was significantly associated with HE, with an adjusted odds ratio of 0.36.
- The area under the ROC curve was 0.635, indicating moderate predictive value of potassium levels for HE.

## Abstract

Serum potassium levels are risk factors for intracerebral hemorrhage (ICH), and haematoma expansion (HE) is an important determinant of poor prognosis in patients with ICH. This study investigated the correlation between serum potassium levels and HE after ICH.

This retrospective study analyzed serum potassium levels in ICH patients. On the basis of imaging criteria (haematoma volume increase ≥33% or absolute enlargement >6 ml), patients were categorized into the HE subgroup. Differences in serum potassium levels were compared using the Mann–Whitney U-test. Propensity score matching (PSM) was applied to balance baseline characteristics between the HE subgroup and the non-HE subgroup for further comparison. Additionally, adjusted logistic regression analyses and receiver operating characteristic (ROC) curves were employed to evaluate the correlation between HE and serum potassium levels.

A total of 310 patients with ICH were identified, of whom 50 (16.1%) had HE. After PSM, patients in the HE subgroup presented lower potassium levels than non-HE patients did (3.71 ± 0.52 vs. 3.92 ± 0.52, p = 0.009). Low serum potassium levels were significantly associated with HE (adjusted Odds Ratio (aOR) = 0.36; 95% CI: 0.15–0.80; p = 0.017), with an AUC value of 0.635.

Low serum baseline potassium levels are associated with a higher risk of HE after ICH. The relevance of serum potassium levels to severity after ICH is emphasized.