Associations between Phosphate Concentrations and Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation

Kim, Beong Ki; Kim, Chi Young; Kim, Sua; Kim, Yu Jin; Lee, Seung Heon; Kim, Je Hyeong

doi:10.3390/jcm11071897

Cited by 5 publications

(11 citation statements)

References 26 publications

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“…The prediction of mechanical ventilation duration could affect both clinical management and intensive care resource utilization. Additionally, comorbidities, such as the presence of chronic respiratory disease, heart failure, cerebrovascular diseases, malnutrition, and end-stage renal failure, affected the duration of mechanical ventilation and the final outcome [ 8 , 9 , 10 ]. Unfortunately, an accurate prediction of mechanical ventilation is quite difficult for critical care physicians according to clinical data at admission.…”

mentioning

confidence: 99%

Risk Factors and Mortality in Elderly ARDS COVID-19 Compared to Patients without COVID-19

Chiumello

Modafferi

Fratti

2022

JCM

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confidence: 99%

Risk Factors and Mortality in Elderly ARDS COVID-19 Compared to Patients without COVID-19

Chiumello

Modafferi

Fratti

2022

JCM

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“…11,16 5 | CONCLUSIONSIn this multicenter cohort study, we found that 50%, 56%, and 91% of the patients presented with abnormal serum magnesium, phosphate, and zinc at ICU admission, and that most patients experienced low serum levels during ICU stay. Patients often received supplementation of magnesium, phosphate, and zinc, and experiencing both low and high serum levels during ICU stay was not uncommon.…”

mentioning

confidence: 74%

“…Therefore, these findings should be interpreted with great caution, and so should the associations between hypermagnesemia and longer time to successful extubation, hyperphosphatemia and shorter duration of mechanical ventilation, hypozincemia and increased mortality, and finally, the associations between high serum levels of magnesium or phosphate and mortality, although increased mortality is in line with most previous findings. 11,12,16,18,20…”

Section: Patient Outcomesmentioning

confidence: 99%

“…Several observational studies have assessed associations between low serum levels of magnesium, phosphate, or zinc and patient outcomes such as mortality and mechanical ventilation, with conflicting results. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] High serum levels, however, may also be of concern. 11,12,16,18,20 Although serum levels probably fluctuate during ICU stay, 11,12,14,16 many studies only used baseline admission serum measurements when assessing associations with mechanical ventilation or mortality.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24] High serum levels, however, may also be of concern. 11,12,16,18,20 Although serum levels probably fluctuate during ICU stay, 11,12,14,16 many studies only used baseline admission serum measurements when assessing associations with mechanical ventilation or mortality. 13,17,19,20,[22][23][24] In this multicenter cohort study of ICU patients, we assessed patient characteristics and the epidemiology of abnormal serum magnesium, phosphate, and zinc levels and of supplementation.…”

Section: Introductionmentioning

confidence: 99%

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

Vesterlund

Thorsen-Meyer

Møller

et al. 2023

Acta Anaesthesiol Scand

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Background Abnormal serum levels of magnesium, phosphate, and zinc appear common in intensive care unit (ICU) patients, but the epidemiology, management, and associations with outcomes are less well described. We described these factors and estimated associations with outcomes in a large dataset of Danish ICU patients. Methods We included adults who were acutely admitted to 10 general ICUs in Denmark between October 2011 and January 2018. From the dataset, we obtained characteristics of patients who had serum levels measured of magnesium, phosphate, or zinc, including data on supplementation. We used joint models with death as a competing outcome to estimate the associations between abnormal serum levels and time to successful extubation and, for magnesium, also incident tachyarrhythmia. Results We included 16,517 of 36,514 patients in the dataset. The cumulative probability of hypomagnesemia within 28 days was 64% (95% confidence interval [CI] 62–66); of hypophosphatemia 74% (95% CI 72–75); and of hypozincemia 98% (95% CI 98–98). Supplementation of magnesium was used in 3554 out of 13,506 (26%) patients, phosphate in 2115 out of 14,148 (15%) patients, and zinc in 4465 out of 9869 (45%) patients. During ICU stay, 38% experienced hypermagnesemia, 58% hyperphosphatemia, and 1% hyperzincemia. Low serum levels of magnesium, phosphate, and zinc were associated with shorter time to successful extubation, and high serum magnesium and phosphate and low serum zinc with the competing risk of increased mortality, but too few serum measurements made the results inconclusive. Conclusion In this multicenter cohort study of acutely admitted ICU patients, most experienced low serum levels of magnesium, phosphate, or zinc during ICU stay, many received supplementation, and experiencing both low and high serum levels during ICU stay was not uncommon. Associations between serum levels and clinical outcomes appeared inconclusive because the data proved unfit for these analyses.

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Analysis of the Relationship Between Early Serum Phosphate Levels and Short-Term Mortality in Septic Patients: A Retrospective Study Based on Mimic-Iv

Xu¹,

Zhang

Liu

et al. 2023

Shock

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The aim of the study is to explore the impact of early serum phosphate levels on the prognosis of critically ill patients with sepsis. Methods: In this retrospective large cohort study, data of patients with sepsis were obtained from the Medical Information Mart for Intensive Care IV database. Patients were retrospectively divided into a control group and three study groups according to their daily serum phosphate levels within 2 days of intensive care unit (ICU) admission. A Cox regression model was used to evaluate the association between serum phosphate levels and 28-day morbidity. Results: This study included 9,691 patients diagnosed with sepsis. During the first 2 days of ICU admission, patients with hyperphosphatemia in either of the 2 days had higher 28-day mortality, while patients in the hypophosphatemia group had lower 28-day mortality (first day, 32.9% vs. 16.3%; second day, 36.3% vs. 14.7%). After adjusting for potential confounders, hyperphosphatemia was significantly associated with 28-day mortality; however, only hypophosphatemia on the second day was independently associated with reduced 28-day mortality. After stratification in the hypophosphatemia group, subgroup analysis showed that only the association between the mild hypophosphatemia group and 28-day mortality reached statistical significance (hazard ratio = 0.76, 95% CI = 0.65-0.89, P = 0.001). Conclusions: Mild hypophosphatemia might improve the short-term prognosis of patients with sepsis, and hyperphosphatemia is an independent risk factor for the outcomes of septic patients. After ICU admission, the serum phosphate levels on the second day had a better independent correlation with 28-day mortality, which prompted us to reconsider the optimal timing of phosphate evaluation.

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Associations between Phosphate Concentrations and Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation

Cited by 5 publications

References 26 publications

Risk Factors and Mortality in Elderly ARDS COVID-19 Compared to Patients without COVID-19

Risk Factors and Mortality in Elderly ARDS COVID-19 Compared to Patients without COVID-19

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

Analysis of the Relationship Between Early Serum Phosphate Levels and Short-Term Mortality in Septic Patients: A Retrospective Study Based on Mimic-Iv

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