Association between phosphate disturbances and mortality among critically ill patients with sepsis or septic shock

BMC Pharmacology and Toxicology

Hani Tamim¹  Hasan M. Al-Dorzi²  Musharaf Sadat²  Yaseen Arabi²  Sheryl Ann I. Abdukahil²  Shmeylan A. Al Harbi³  Albatool M. Al Meshari⁴ 

[1] Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Department of Internal Medicine, American University of Beirut- Medical Center, Beirut, Lebanon;King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;Intensive Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia;College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia;King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;Saudi Food and Drug Authority, Riyadh, Saudi Arabia;

关键词: Phosphate;    Mortality;    Sepsis;    Septic shock;    Critically ill;    Intensive care;    Saudi Arabia;   

DOI  :  10.1186/s40360-021-00487-w

来源: Springer

【 摘 要 】

ObjectiveThe aim of this study is to examine the association of hypophosphatemia and hyperphosphatemia on the first day of ICU admission with mortality in septic critically ill patients.MethodsIn this retrospective cohort study, all adult patients who were admitted to the medical-surgical ICUs between 2014 and 2017 with sepsis or septic shock were categorized as having hypophosphatemia, normophosphatemia and hyperphosphatemia based on day 1 serum phosphate values. We compared the clinical characteristics and outcomes between the three groups. We used multivariate analysis to examine the association of hypophosphatemia and hyperphosphatemia with these outcomes.ResultsOf the 1422 patients enrolled in the study, 188 (13%) had hypophosphatemia, 865 (61%) normophosphatemia and 369 (26%) had hyperphosphatemia. The patients in the hyperphosphatemia group had significantly lower GCS, higher APACHE II scores, higher serum creatinine, increased use of vasopressors, and required more mechanical ventilation with lower PaO2/FiO2 ratio compared with the other two groups. In addition, the hyperphosphatemia group showed significantly higher ICU and hospital mortality in comparison with the other two groups.ConclusionHyperphosphatemia and not hypophosphatemia on the first ICU admission day was associated with an increase in the ICU and hospital mortality in septic critically ill patients.

【 授权许可】

CC BY