Impact of serum phosphate changes on in-hospital mortality

BMC Nephrology

Panupong Hansrivijit¹  Kianoush B. Kashani²  Charat Thongprayoon²  Api Chewcharat²  Sorkko Thirunavukkarasu²  Michael A. Mao³  Wisit Cheungpasitporn⁴  Juan Medaura⁴ 

[1] Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle;Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic;Division of Nephrology and Hypertension, Mayo Clinic;Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center;

关键词: Phosphate;    Electrolytes;    Hypophosphatemia;    Hyperphosphatemia;    Mortality;   

DOI  :  10.1186/s12882-020-02090-3

来源: DOAJ

【 摘 要 】

Abstract Background Fluctuations in serum phosphate levels increased mortality in end-stage renal disease patients. However, the impacts of serum phosphate changes in hospitalized patients remain unclear. This study aimed to test the hypothesis that serum phosphate changes during hospitalization were associated with in-hospital mortality. Methods We included all adult hospitalized patients from January 2009 to December 2013 that had at least two serum phosphate measurements during their hospitalization. We categorized in-hospital serum phosphate changes, defined as the absolute difference between the maximum and minimum serum phosphate, into 5 groups: 0–0.6, 0.7–1.3, 1.4–2.0, 2.1–2.7, ≥2.8 mg/dL. Using serum phosphate change group of 0–0.6 mg/dL as the reference group, the adjusted odds ratio of in-hospital mortality for various serum phosphate change groups was obtained by multivariable logistic regression analysis. Results A total of 28,149 patients were studied. The in-hospital mortality in patients with serum phosphate changes of 0–0.6, 0.7–1.3, 1.4–2.0, 2.1–2.7, ≥2.8 mg/dL was 1.5, 2.0, 3.1, 4.4, and 10.7%, respectively (p < 0.001). When adjusted for confounding factors, larger serum phosphate changes were associated with progressively increased in-hospital mortality with odds ratios of 1.35 (95% 1.04–1.74) in 0.7–1.3 mg/dL, 1.98 (95% CI 1.53–2.55) in 1.4–2.0 mg/dL, 2.68 (95% CI 2.07–3.48) in 2.1–2.7 mg/dL, and 5.04 (95% CI 3.94–6.45) in ≥2.8 mg/dL compared to serum phosphate change group of 0–0.6 mg/dL. A similar result was noted when we further adjusted for either the admission or mean serum phosphate during hospitalization. Conclusion Greater serum phosphate changes were progressively associated with increased in-hospital mortality.

【 授权许可】

Unknown