Hypophosphatemia in critically ill patients.

Details

Serval ID
serval:BIB_A4C067C20ED1
Type
Article: article from journal or magazin.
Collection
Publications
Title
Hypophosphatemia in critically ill patients.
Journal
Journal of Critical Care
Author(s)
Suzuki S., Egi M., Schneider A.G., Bellomo R., Hart G.K., Hegarty C.
ISSN
1557-8615 (Electronic)
ISSN-L
0883-9441
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
28
Number
4
Pages
536.e9-536.19
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
PURPOSE: The aim of this study was to assess the association of phosphate concentration with key clinical outcomes in a heterogeneous cohort of critically ill patients.
MATERIALS AND METHODS: This was a retrospective observational study at a general intensive care unit (ICU) of an Australian university teaching hospital enrolling 2730 adult critically ill patients.
RESULTS: We studied 10504 phosphate measurements with a mean value of 1.17 mmol/L (measurements every 28.8 hours on average). Hyperphosphatemia (inorganic phosphate [iP] concentration > 1.4 mmol/L) occurred in 45% and hypophosphatemia (iP ≤ 0.6 mmol/L) in 20%. Among patients without any episodes of hyperphosphatemia, patients with at least 1 episode of hypophosphatemia had a higher ICU mortality than those without hypophosphatemia (P = .004). In addition, ICU nonsurvivors had lower minimum phosphate concentrations than did survivors (P = .009). Similar results were seen for hospital mortality. However, on multivariable logistic regression analysis, hypophosphatemia was not independently associated with ICU mortality (adjusted odds ratio, 0.86 [95% confidence interval, 0.66-1.10]; P = .24) and hospital mortality (odds ratio, 0.89 [0.73-1.07]; P = .21). Even when different cutoff points were used for hypophosphatemia (iP ≤ 0.5, 0.4, 0.3, or 0.2 mmol/L), hypophosphatemia was not an independent risk factor for ICU and hospital morality. In addition, timing of onset and duration of hypophosphatemia were not independent risk factor for ICU and hospital mortality.
CONCLUSIONS: Hypophosphatemia behaves like a general marker of illness severity and not as an independent predictor of ICU or in-hospital mortality in critically ill patients.
Keywords
Aged, Chi-Square Distribution, Critical Illness/mortality, Female, Hospital Mortality, Humans, Hypophosphatemia/mortality, Intensive Care Units, Logistic Models, Male, Middle Aged, Retrospective Studies, Risk Factors, Statistics, Nonparametric, Survival Rate
Pubmed
Web of science
Create date
26/11/2014 21:42
Last modification date
20/08/2019 15:10
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