Ding Yiyi, Lei Yaqin, Zhu Yufang, Zhang Hongwei, Xiao Yunbin
Jinan University, Guangzhou, Guangdong, China.
Department of Pediatrics, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, Hunan, China.
BMJ Paediatr Open. 2024 Dec 31;8(1):e003171. doi: 10.1136/bmjpo-2024-003171.
Death rates in the intensive care unit (ICU) and paediatric ICU (PICU) are approximately 10.8% and 9.13%, respectively. Serum phosphate irregularities, such as low or high phosphate levels, significantly impact ICU patient outcomes. However, the connection between serum phosphate concentrations on admission and PICU mortality has not been investigated.
Information was collected from 12 881 PICU patients at the Children's Hospital, Zhejiang University School of Medicine, over an 8-year period from 2010 to 2018. The data were retrieved from the PIC database (http://pic.nbscn.org).
A multiple linear regression model was used to assess associations between phosphate and 30-day PICU mortality, finding a significant positive relationship (OR 1.27, 95% CI 1.08 to 1.49). Generalised additive models were also developed, showing a non-linear association between serum phosphate and 30-day PICU mortality. In the two-phase linear regression analysis, the critical point for serum phosphate concentration was identified as 1.2 mmol/L. To the left of this point, serum phosphate levels were inversely correlated (OR 0.2, 95% CI 0.10 to 0.41), whereas to the right, a positive relationship was observed (OR 1.99, 95% CI 1.66 to 2.39).
The findings demonstrated a relationship between serum phosphate levels and 30-day PICU mortality. The relationship was represented by a U-shaped curve. Hypophosphataemia and hyperphosphataemia increased the risk of 30-day PICU death.
重症监护病房（ICU）和儿科重症监护病房（PICU）的死亡率分别约为10.8%和9.13%。血清磷酸盐异常，如低磷酸盐水平或高磷酸盐水平，会显著影响ICU患者的预后。然而，入院时血清磷酸盐浓度与PICU死亡率之间的关系尚未得到研究。
收集了2010年至2018年8年间浙江大学医学院附属儿童医院12881例PICU患者的信息。数据从PIC数据库（http://pic.nbscn.org）中检索。
采用多元线性回归模型评估磷酸盐与PICU 30天死亡率之间的关联，发现存在显著正相关（比值比1.27，95%置信区间1.08至1.49）。还建立了广义相加模型，显示血清磷酸盐与PICU 30天死亡率之间存在非线性关联。在两阶段线性回归分析中，血清磷酸盐浓度的临界点确定为1.2 mmol/L。在该点左侧，血清磷酸盐水平呈负相关（比值比0.2，95%置信区间0.10至0.41），而在右侧，则观察到正相关（比值比1.99，95%置信区间1.66至2.39）。
研究结果表明血清磷酸盐水平与PICU 30天死亡率之间存在关联。这种关系呈U形曲线。低磷血症和高磷血症增加了PICU 30天死亡的风险。
