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Title: Hypophosphatemia in critically ill patients.
Austin Authors: Suzuki, Satoshi;Egi, Moritoki;Schneider, Antoine G;Bellomo, Rinaldo ;Hart, Graeme K ;Hegarty, Colin
Affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia
Issue Date: 21-Dec-2012
Publication information: Journal of Critical Care 2012; 28(4): 536.e9-19
Abstract: 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.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.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.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.
Gov't Doc #: 23265292
DOI: 10.1016/j.jcrc.2012.10.011
Journal: Journal of Critical Care
Type: Journal Article
Subjects: Critical illness
Inorganic phosphate
Intensive care unit
Chi-Square Distribution
Critical Illness.mortality
Hospital Mortality
Intensive Care Units
Logistic Models
Middle Aged
Retrospective Studies
Risk Factors
Statistics, Nonparametric
Survival Rate
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