Abnormal serum levels of magnesium, phosphate, and zinc in <scp>ICU</scp> patients—Characteristics, management, and outcomes: The <scp>WhyTrace</scp> cohort study

Vesterlund, Gitte Kingo; Thorsen-Meyer, Hans-Christian; Møller, Morten Hylander; Brunak, Søren; Strøm, Thomas; Perner, Anders; Kaas‐Hansen, Benjamin Skov

doi:10.1111/aas.14247

Cited by 4 publications

(3 citation statements)

References 37 publications

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“…ICU patients are at high risk of depletion of magnesium and phosphate [ 23 ]. Anne-Louise Hother et al reported that serum magnesium and phosphorus levels are positively correlated in children admitted with acute malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for predicting early hypophosphatemia in term infants

Tao,

Zhan,

Shen

et al. 2024

BMC Pediatr

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Background Physiological processes rely on phosphate, which is an essential component of adenosine triphosphate (ATP). Hypophosphatasia can affect nearly every organ system in the body. It is crucial to monitor newborns with risk factors for hypophosphatemia and provide them with the proper supplements. We aimed to evaluate the risk factors and develop a nomogram for early hypophosphatemia in term infants. Methods We conducted a retrospective study involving 416 term infants measured serum phosphorus within three days of birth. The study included 82 term infants with hypophosphatemia (HP group) and 334 term infants without hypophosphatemia (NHP group). We collected data on the characteristics of mothers, newborn babies, and childbirth. Furthermore, univariate and multivariate logistic regression analyses were performed to identify independent risk factors for hypophosphatemia in term infants, and a nomogram was developed and validated based on the final independent risk factors. Results According to our analysis, the multivariate logistic regression analysis showed that male, maternal diabetes, cesarean delivery, lower serum magnesium, and lower birth weight were independent risk factors for early hypophosphatemia in term infants. In addition, the C-index of the developed nomogram was 0.732 (95% CI = 0.668–0.796). Moreover, the calibration curve indicated good consistency between the hypophosphatemia diagnosis and the predicted probability, and a decision curve analysis (DCA) confirmed the clinical utility of the nomogram. Conclusions The analysis revealed that we successfully developed and validated a nomogram for predicting early hypophosphatemia in term infants.

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Section: Discussionmentioning

confidence: 99%

Nomogram for predicting early hypophosphatemia in term infants

Tao,

Zhan,

Shen

et al. 2024

BMC Pediatr

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“…To date, most of previous studies addressed that hyperphosphatemia at admission could be an independent risk factor for mortality in critical illness [ 14 , 15 , 17 , 18 , 41 – 43 ]. On the contrary, the association between hypophosphatemia and clinical outcome was inconsistent in recent studies.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ]. Varied definitions of phosphate abnormality: the cut-off value for hypophosphatemia varied from 0.6 to 1.09 mmol/L [ 7 , 14 , 15 , 18 , 24 , 44 ], and the cut-off value for hyperphosphatemia varied from 1.23 to 1.94mmol/L [ 15 , 18 , 24 , 44 , 49 ]. Besides, some studies used the lowest or highest quartile of serum phosphate as the low or high phosphate level [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

The association between serum phosphate and length of hospital stay and all-cause mortality in adult patients: a cross-sectional study

Zhou,

Zhang,

Chen

et al. 2024

Nutr J

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Background Data is limited on the prevalence of hypophosphatemia in general hospitalized patients, and its association with length of hospital stay (LOS) and mortality remained unclear. We aimed to investigate the prevalence of admission phosphate abnormality and the association between serum phosphate level and length of hospital stay and all-cause mortality in adult patients. Methods This was a multi-center retrospective study based on real-world data. Participants were classified into five groups according to serum phosphate level (inorganic phosphorus, iP) within 48 h after admission: G1, iP < 0.64 mmol/L; G2, iP 0.64–0.8 mmol/L; G3, iP 0.8–1.16 mmol/L; G4, iP 1.16–1.45 mmol/L; and G5, iP ≥ 1.45 mmol/L, respectively. Both LOS and in-hospital mortality were considered as outcomes. Clinical information, including age, sex, primary diagnosis, co-morbidity, and phosphate-metabolism related parameters, were also abstracted from medical records. Results A total number of 23,479 adult patients (14,073 males and 9,406 females, aged 57.7 ± 16.8 y) were included in the study. The prevalence of hypophosphatemia was 4.74%. An “L-shaped” non-linear association was determined between serum phosphate level and LOS and the inflection point was 1.16 mmol/L in serum phosphate level. Compared with patients in G4, patients in G1, G2 or G3 were significantly associated with longer LOS after full adjustment of covariates. Each 0.1 mmol/L decrease in serum phosphate level to the left side of the inflection point led to 0.64 days increase in LOS [95% confidence interval (CI): 0.46, 0.81; p for trend < 0.001]. But there was no association between serum phosphate and LOS where serum levels of phosphate ≥ 1.16 mmol/L. Multivariable logistic regression analysis showed that adjusted all-cause in-hospital mortality was 3.08-fold greater in patients in G1 than those in G4 (95% CI: 1.52, 6.25; p for trend = 0.001). Similarly, no significant association with either LOS or mortality were found in patients in G5, comparing with G4. Conclusions Hypophosphatemia, but not hyperphosphatemia, was associated with LOS and all-cause mortality in adult inpatients. It is meaningful to monitor serum levels of phosphate to facilitate early diagnosis and intervention.

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