Division of Hematology/Oncology, Department of Pediatrics, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; Department of Pediatric Intensive Care Unit, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China.
Department of Intensive Care Unit, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510000, China.
Clin Biochem. 2021 May;91:9-15. doi: 10.1016/j.clinbiochem.2021.01.016. Epub 2021 Feb 15.
Sepsis is the leading cause of hospitalization and death in the intensive care unit. It is vital to identify high-risk patients with poor prognosis in the early stages of sepsis. We aimed to investigate the prognostic value of serum phosphorus levels for sepsis.
The data of 4767 patients with sepsis were collected from the Multiparameter Intelligent Monitoring in Intensive Care III database. The Locally Weighted Scatterplot Smoothing technique and Kaplan-Meier analysis were used to test the crude relationship between serum phosphorus levels and mortality or overall survival. The multivariable logistic regression was used to further analyze the relationship between serum phosphorus levels and in-hospital mortality. The subgroup analysis was performed according to renal failure, use of vasopressin and the Sequential Organ Failure Assessment (SOFA) score.
Only hyperphosphatemia significantly correlated with in-hospital mortality [odds ratio (OR) 1.48; 95% confidence interval (CI) 1.19-1.85], while the correlation between hypophosphatemia and in-hospital mortality was not significant (OR 0.91; 95% CI 0.70-1.19). The interactions between serum phosphorus and renal failure, use of vasopressin or the SOFA score were not significant.
Hyperphosphatemia rather than hypophosphatemia indicates a poor prognosis in patients with sepsis.
脓毒症是重症监护病房住院和死亡的主要原因。在脓毒症的早期阶段，识别预后不良的高危患者至关重要。我们旨在探讨血清磷水平对脓毒症的预后价值。
从 Multiparameter Intelligent Monitoring in Intensive Care III 数据库中收集了 4767 例脓毒症患者的数据。使用局部加权散点平滑技术和 Kaplan-Meier 分析测试血清磷水平与死亡率或总生存率之间的粗关系。使用多变量逻辑回归进一步分析血清磷水平与住院死亡率之间的关系。根据肾功能衰竭、血管加压素的使用和序贯器官衰竭评估 (SOFA) 评分进行亚组分析。
只有高磷血症与住院死亡率显著相关[比值比 (OR) 1.48；95%置信区间 (CI) 1.19-1.85]，而低磷血症与住院死亡率之间的相关性不显著(OR 0.91；95%CI 0.70-1.19)。血清磷与肾功能衰竭、血管加压素使用或 SOFA 评分之间的交互作用不显著。
高磷血症而不是低磷血症表明脓毒症患者预后不良。
