Association of Preoperative Serum Potassium With Postoperative Seizures in Patients Undergoing Elective Craniotomy

BACKGROUND AND OBJECTIVES: Patients who undergo craniotomy are at risk of developing seizures during the postoperative period. Preoperative serum potassium as an important potential risk factor has not been investigated yet. METHODS: We conducted a retrospective cohort study involving adults undergoing elective craniotomy at West China Hospital, from January 2011 and March 2021. The main outcome of this study was postoperative seizures in patients undergoing elective craniotomy during hospitalization. We performed univariable and multivariable logistic regression to investigate the association of preoperative serum potassium with postoperative seizures. RESULTS: A total of 15 041 patients were collected after filtering by excluded criteria. The incidence of postoperative seizures was 4.87%. We identified a linear relationship between preoperative serum potassium and postoperative seizures ( P for nonlinearity =.87). Compared with patients with serum potassium 3.5 to 4.5 mmol/L, the odds of postoperative seizures increased in patients with serum potassium ≥4.5 mmol/L (the adjusted odds ratios 1.46, 95% CI 1.10-1.93), and the odds of postoperative seizures decreased in patients with serum potassium ≤3.5 mmol/L (the adjusted odds ratios 0.73, 95% CI 0.53-1.01). CONCLUSION: We found that high preoperative serum potassium level was associated with the high risk of postoperative seizures in patients undergoing craniotomy. We demonstrated that preoperative serum potassium level was the independent risk factor of postoperative seizures.