Li Kun, Cao Shuo, Qin Kexiang, Luo Ju, Ding Ning
Department of Chinese and Western Integrative Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China.
Department of Gastroenterology, Third Xiangya Hospital, Central South University.
Pancreas. 2025 May 1;54(5):e474-e481. doi: 10.1097/MPA.0000000000002455.
Acute pancreatitis (AP) is the most common disease in emergency and intensive care units; early mortality predictions and intervention are crucial for improving patient prognosis. We investigated the association of serum phosphate with mortality among AP patients using a large public database.
This was a retrospective study. All AP patients in the MIMIC-IV database were included. Based on the tertiles of serum phosphate, all AP patients were divided into 3 groups. Two generalized additive models were performed to explore the association of serum phosphate with in-hospital and 30-day mortality. Kaplan-Meier analysis was introduced for survival probability.
A total of 1088 AP patients admitted to the ICU were included. The mortalities of in-hospital (n=137) and 30-day (n=118) were 12.59% and 10.85%, respectively. The median levels of serum phosphate in the survivor and the non-survivor groups were 3.20 and 3.90 mg/dL, respectively (P<0.001). After adjusting for all potential confounders, with 1 mg/dL increment in serum phosphate, the risk of in-hospital and 30-day mortality increased by 20% (HR=1.20, 95% CI: 1.00-1.44, P=0.0443) and 25% (HR=1.25, 95% CI: 1.03-1.52, P=0.0214), respectively. The areas under the ROC curve (AUC) of serum phosphate for predicting in-hospital and 30-day mortality were 0.650 (95% CI: 0.599-0.701) and 0.659 (95% CI: 0.605-0.714), respectively. The cutoff values of serum phosphate were 3.65 and 4.35 mg/dL, respectively.
A linear positive relationship was found between serum phosphate and in-hospital and 30-day mortality in AP. Serum phosphate was associated with in-hospital and 30-day mortality in AP. Our results could be used for screening out those AP patients with a higher risk of worse outcomes.
急性胰腺炎（AP）是急诊和重症监护病房中最常见的疾病；早期死亡率预测和干预对于改善患者预后至关重要。我们使用一个大型公共数据库研究了AP患者血清磷酸盐与死亡率之间的关联。
这是一项回顾性研究。纳入了多中心重症医学信息数据库（MIMIC-IV）中的所有AP患者。根据血清磷酸盐的三分位数，将所有AP患者分为3组。进行了两个广义相加模型以探讨血清磷酸盐与住院期间及30天死亡率之间的关联。采用Kaplan-Meier分析计算生存概率。
共纳入1088例入住重症监护病房的AP患者。住院期间死亡137例，死亡率为12.59%；30天内死亡118例，死亡率为10.85%。存活组和非存活组血清磷酸盐的中位数水平分别为3.20和3.90mg/dL（P<0.001）。在调整所有潜在混杂因素后，血清磷酸盐每增加1mg/dL，住院期间和30天死亡率的风险分别增加20%（HR=1.20，95%CI：1.00-1.44，P=0.0443）和25%（HR=1.25，95%CI：1.03-1.52，P=0.0214）。血清磷酸盐预测住院期间和30天死亡率的ROC曲线下面积（AUC）分别为0.650（95%CI：0.599-0.701）和0.659（95%CI：0.605-0.714）。血清磷酸盐的截断值分别为3.65和4.35mg/dL。
发现AP患者血清磷酸盐与住院期间及30天死亡率之间存在线性正相关。血清磷酸盐与AP患者的住院期间及30天死亡率相关。我们的结果可用于筛选出预后较差风险较高的AP患者。
