Hypophosphataemia at a large academic hospital in South Africa

Abstract

Severe hypophosphataemia is associated with a very high mortality (30%, n = 189). Patients with a high risk of developing hypophosphataemia include those in an intensive care unit (ICU), patients suffering from neoplastic diseases, possible refeeding syndrome and septic patients. Regular phosphate determination is recommended in these patients to facilitate early diagnosis of hypophosphataemia.

Refeeding hypophosphatemia: a potentially fatal danger in the intensive care unit

“…There were significant discrepancies between the studies regarding the incidence of RH (4,18,27). In a study by Marik and Bedigian (18), performed in both medical and surgical ICU patients, they reported RH incidence of 34%, which was lower than our results.…”

“…Advanced age, chronic disease, and malignant disorders may contribute to hypophosphatemia by causing malnutrition. In another study, Hoffman et al (4) found the rate of hypophosphatemia to be 45% in an ICU. However, this rate was for all causes of hypophosphatemia, not just for RH (4).…”

“…In another study, Hoffman et al (4) found the rate of hypophosphatemia to be 45% in an ICU. However, this rate was for all causes of hypophosphatemia, not just for RH (4). RH was commonly observed in patients receiving PN due to high levels of glucose in PN solutions, which stimulates insulin secretion, and this hyperinsulinemic state leads to hypophosphatemia, hypopotassemia, and hypomagnesemia (18).…”

“…There exist data showing that hypophosphatemia may be related to increased mortality rate; however, there are very limited data showing the relation between mortality rate and RH. Hoffmann et al (4) showed a 30% mortality rate in hospitalized patients with severe hypophosphatemia. There was no increased mortality rate in the first 7 days of ICU stay in a study performed by Zeki et al (17), and, similarly, Lubart et al (30) did not find an increased mortality rate for 7 days and 1 month in 40 elderly patients with RH.…”

“…Low serum phosphate concentrations (<0.80 mmol/L) are present in 5%-10% of hospitalized patients. The prevalence of RH varies from 25% to 45% in patients treated in intensive care units (ICUs) or outpatient services (4,17,18).…”