Effect of Serum Phosphate on the Prognosis of Septic Patients: A Retrospective Study Based on MIMIC-IV Database

Frontiers in Medicine

article

Zhaoyang Li¹  Tingwen Shen²  Yi Han³ 

[1] Department of Intensive Care Medicine, The First Affiliated Hospital of Nanjing Medical University;The Health Management Center, The First Affiliated Hospital of Nanjing Medical University;Department of Geriatric Intensive Care Medicine, The First Affiliated Hospital of Nanjing Medical University

关键词: sepsis-3;    phosphate levels;    prognosis;    MIMIC-IV;    septic shock;   

DOI  :  10.3389/fmed.2022.728887

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective To assess the effect of serum inorganic phosphate (Pi) on the prognosis of patients with sepsis. Methods A retrospective analysis of patients with sepsis selected from the Medical Information Mart for Intensive Care (MIMIC)-IV database was performed. Sepsis was diagnosed according to the Third International Consensus Definition for sepsis and septic shock (Sepsis-3). The time-weighted values of the serum Pi measurements within the first 24 h of sepsis were analyzed. The association between serum Pi and in-hospital mortality was evaluated with a generalized linear model (log-binomial model). Results The analysis of 11,658 patients from six intensive care units (ICUs) showed a nearly linear correlation between serum Pi and in-hospital mortality in all patients with sepsis, especially in those with acute kidney injury (AKI). The increase of serum Pi was related to a higher risk of AKI, higher norepinephrine doses, ICU mortality, and in-hospital mortality. The generalized linear model showed that serum Pi was an independent predictor for in-hospital mortality in all patients with sepsis even within the normal range. The adjusted risk ratios (RRs) were also significant in subgroup analyses according to kidney function, gender, respiratory infection, vasopressor use, and Sequential Organ Failure Assessment (SOFA) score. Conclusion Higher levels of serum Pi, even within the normal range, were significantly associated with a higher risk of in-hospital mortality in patients with sepsis regardless of kidney function, gender, respiratory infection, vasopressor use, and SOFA score.

【 授权许可】

CC BY