The role of serum phosphate level and acute ischemic bowel disease.

The objectives of this study were to determine whether an elevated serum phosphate level is predictive of acute ischemic bowel disease and whether it serves as a prognostic indicator in patients with intestinal ischemia. A retrospective chart review was performed at an urban teaching hospital emergency department. Twenty-three patients with documented acute ischemic bowel disease from 1990 through 1994 were compared with 27 patients with acute abdominal disease entities unrelated to intestinal ischemia. The sensitivity, specificity, and positive and negative predictive values of serum phosphate were 26%, 85%, 60%, and 58% respectively. Levels of phosphate in patients with intestinal ischemia versus controls were 4.20 versus 3.41 mg/dL (P = .1338). The length of bowel necrosis in the experimental group with elevated phosphate versus normal phosphate level was 57.53 cm versus 99.00 cm (P = .4132). Although not statistically significant, linear regression revealed slightly positive correlations in those with elevated phosphate versus normal phosphate level (in the experimental group) with the length of bowel necrosis and duration of hospital stay as r= .155 (P = .4813) and r= .134 (P= .5418), respectively. Serum phosphate level independently has no diagnostic or prognostic value in acute ischemic bowel disease.