Li Siqi, Huang Qiong, Nan Wenbin, He Baimei
Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
Heliyon. 2023 Sep 6;9(9):e19748. doi: 10.1016/j.heliyon.2023.e19748. eCollection 2023 Sep.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important adverse event in the development of chronic obstructive pulmonary disease (COPD). Hyperphosphatemia is associated with higher mortality in patients with multiple diseases. In this study, we aimed to determine the relationship between serum phosphate and the risk of in-hospital mortality in patients with AECOPD. : In the present study, patients with AECOPD were enrolled in the electronic Intensive Care Unit Collaborative Research Database (eICU-CRD), and divided into three groups according to the tertiles of serum phosphate level. The primary outcome measure was all-cause in-hospital mortality. The association between serum phosphate level and in-hospital mortality was investigated using multivariate logistic regression analysis. Moreover, subgroup analysis was performed to explore whether the relationship was consistent among different subgroups. A total of 1199 AECOPD patients were included in this study. Non-survivors had higher serum phosphate levels than survivors. All patients were classified into lowest tertile, median tertile, and highest tertile, respectively. Multivariate logistic regression analysis indicated that serum phosphate was positively associated with in-hospital mortality after adjusting for confounders. Moreover, there was a significant trend across tertiles when serum phosphate level was diverted as a categorical variable. In addition, subgroup analysis demonstrated that serum phosphate was consistently associated with a higher risk of in-hospital mortality in different subgroups. Higher serum phosphate was positively associated with the increased in-hospital mortality in patients with AECOPD. Hyperphosphatemia may be an underlying high-risk factor for in-hospital mortality owing to AECOPD.
慢性阻塞性肺疾病急性加重（AECOPD）是慢性阻塞性肺疾病（COPD）发展过程中的一项重要不良事件。高磷血症与多种疾病患者的较高死亡率相关。在本研究中，我们旨在确定AECOPD患者血清磷酸盐水平与院内死亡风险之间的关系。在本研究中，AECOPD患者被纳入电子重症监护病房协作研究数据库（eICU-CRD），并根据血清磷酸盐水平的三分位数分为三组。主要结局指标是全因院内死亡率。采用多因素逻辑回归分析研究血清磷酸盐水平与院内死亡率之间的关联。此外，进行亚组分析以探讨不同亚组之间的关系是否一致。本研究共纳入1199例AECOPD患者。非幸存者的血清磷酸盐水平高于幸存者。所有患者分别被分为最低三分位数组、中位数三分位数组和最高三分位数组。多因素逻辑回归分析表明，在调整混杂因素后，血清磷酸盐与院内死亡率呈正相关。此外，当将血清磷酸盐水平作为分类变量进行分析时，三分位数之间存在显著趋势。此外，亚组分析表明，血清磷酸盐在不同亚组中均与较高的院内死亡风险持续相关。较高的血清磷酸盐水平与AECOPD患者院内死亡率增加呈正相关。高磷血症可能是AECOPD导致院内死亡的一个潜在高危因素。
