Sin Jeremy Cheuk Kin, Laupland Kevin B, Ramanan Mahesh, Tabah Alexis
Department of Anaesthesia, Redcliffe Hospital, Redcliffe, Queensland, Australia; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
J Crit Care. 2021 Aug;64:154-159. doi: 10.1016/j.jcrc.2021.03.012. Epub 2021 Apr 18.
We investigated the effect of serum phosphate abnormalities at intensive care unit (ICU) admission on risk of death and length of stay in critically ill patients.
A retrospective cohort of patients admitted to three adult ICUs in Queensland, Australia from April 2014 to 2019 was studied. Hypophosphataemia, normophosphataemia and hyperphosphataemia were defined as serum phosphate level of <0.8, 0.8-1.5 and >1.5 mmol/L respectively. Univariable and logistic regression analyses were performed to investigate the association between the phosphate groups and the risk of death.
We included 13,155 patients in the analysis, of which 1424 (10.8%) patients had hypophosphataemia and 2544 (19.3%) hyperphosphataemia. The mean admission phosphate level was 1.25 (SD, ±0.43) mmol/L. Both hypophosphatemia (OR 1.29; 95% CI, 1.02-1.64; p = 0.034) and hyperphosphataemia (OR 1.39; 95% CI, 1.15-1.68; p = 0.001) at admission were independently associated with increased risk of death after adjusting for covariables using logistic regression analysis.
Hypophosphatemia and hyperphosphatemia were both independently associated with an increased case fatality rate and ICU length of stay in a large multicentre ICU cohort.
我们研究了重症监护病房（ICU）入院时血清磷酸盐异常对危重症患者死亡风险和住院时间的影响。
对2014年4月至2019年期间澳大利亚昆士兰州三家成人ICU收治的患者进行回顾性队列研究。低磷血症、正常磷血症和高磷血症分别定义为血清磷酸盐水平<0.8、0.8 - 1.5和>1.5 mmol/L。进行单变量和逻辑回归分析以研究磷酸盐组与死亡风险之间的关联。
我们纳入了13155例患者进行分析，其中1424例（10.8%）患者患有低磷血症，2544例（19.3%）患有高磷血症。入院时磷酸盐的平均水平为1.25（标准差，±0.43）mmol/L。使用逻辑回归分析对协变量进行调整后，入院时的低磷血症（比值比1.29；95%置信区间，1.02 - 1.64；p = 0.034）和高磷血症（比值比1.39；95%置信区间，1.15 - 1.68；p = 0.001）均与死亡风险增加独立相关。
在一个大型多中心ICU队列中，低磷血症和高磷血症均与病死率增加和ICU住院时间延长独立相关。
