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<div><p>Objective</p><p>Potassium ion disorders are prevalent among patients in Intensive Care Units (ICUs), yet there is a notable deficiency in established protocols and supplemental plans for potassium management. This retrospective study conducted at a single center aims to explore the relationship between potassium levels, their variability, and the 28-day mortality rate in ICU patients.</p><p>Methods</p><p>This study analyzed data from patients admitted to the ICU of the First Affiliated Hospital of Guangxi Medical University between October 2022 and October 2023. We assessed serum potassium variability using the coefficient of variation and categorized it into four quartile groups (Q1, Q2, Q3, Q4). Additionally, patients were classified into six groups based on serum potassium concentrations. The associations between these categories and the 28-day mortality rate were evaluated using binary logistic regression, adjusting for potential confounders.</p><p>Results</p><p>A total of 506 patients and 12,099 potassium measurements were analyzed. The group with the lowest potassium variability (Q1) exhibited the lowest mortality rate at 21% (P<0.01). It is noteworthy that within 28 days in the intensive care unit (ICU), the coefficient of variation (CV) of potassium levels significantly increased among deceased patients compared to surviving patients (P < 0.01).</p><p>Conclusion</p><p>Significant variability in potassium levels is associated with an increased risk of 28-day mortality among ICU patients, underscoring the need for stringent monitoring and management of potassium levels in this population.</p></div>