Wozniak Hannah, Dos Santos Rocha André, Beckmann Tal Sarah, Larpin Christophe, Buetti Niccolò, Quintard Hervé, Pugin Jérôme, Heidegger Claudia Paula
Division of Intensive Care, Department of Acute Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland.
Division of Anesthesiology, Department of Acute Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland.
J Clin Med. 2022 Jan 24;11(3):581. doi: 10.3390/jcm11030581.
Hypophosphatemia is frequently observed in the ICU and is associated with several impairments such as respiratory failure or infections. We hypothesized that hypophosphatemia on ICU admission is associated with a prolonged duration of mechanical ventilation and ICU length of stay (LOS), particularly in COVID-19 patients. This cross-sectional study analyzed data from 1226 patients hospitalized in the ICU of the Geneva University Hospitals from August 2020 to April 2021. Patients were categorized as having hypophosphatemia (phosphatemia ≤ 0.8 mmol/L) or non-hypophosphatemia (phosphatemia > 0.8 mmol/L) on ICU admission. Linear regressions were performed to investigate the association between hypophosphatemia on ICU admission and ICU LOS and duration of mechanical ventilation. Overall, 250 (20%) patients presented hypophosphatemia on ICU admission. In the univariable analysis, hypophosphatemic patients had longer ICU LOS than non-hypophosphatemic patients, 7.4 days (±10.4) versus 5.6 days (±8.3), ( < 0.01). Hypophosphatemia on ICU admission was associated with a prolonged duration of mechanical ventilation, 7.4 days (±11.2) versus 5.6 days (±8.9), ( < 0.01). These associations were confirmed in the multivariable analysis ( < 0.01). In the subgroup of COVID-19 patients, a significant association between hypophosphatemia and ICU LOS and duration of mechanical ventilation was also observed. In conclusion, hypophosphatemia on ICU admission is associated with a longer ICU LOS and time under mechanical ventilation, both in the general ICU population and in COVID-19 patients.
低磷血症在重症监护病房（ICU）中很常见，并且与呼吸衰竭或感染等多种损伤有关。我们推测，入住ICU时的低磷血症与机械通气时间延长和ICU住院时间（LOS）相关，尤其是在新冠肺炎患者中。这项横断面研究分析了2020年8月至2021年4月在日内瓦大学医院ICU住院的1226例患者的数据。根据入住ICU时的血磷水平，将患者分为低磷血症组（血磷≤0.8 mmol/L）和非低磷血症组（血磷>0.8 mmol/L）。进行线性回归分析以研究入住ICU时的低磷血症与ICU住院时间和机械通气时间之间的关联。总体而言，250例（20%）患者入住ICU时出现低磷血症。在单变量分析中，低磷血症患者的ICU住院时间比非低磷血症患者更长，分别为7.4天（±10.4）和5.6天（±8.3），（P<0.01）。入住ICU时的低磷血症与机械通气时间延长相关，分别为7.4天（±11.2）和5.6天（±8.9），（P<0.01）。这些关联在多变量分析中得到证实（P<0.01）。在新冠肺炎患者亚组中，也观察到低磷血症与ICU住院时间和机械通气时间之间存在显著关联。总之，入住ICU时的低磷血症与更长的ICU住院时间和机械通气时间相关，这在普通ICU患者群体和新冠肺炎患者中均如此。
