Hypophosphataemia is common in patients with aneurysmal subarachnoid haemorrhage

Abstract

Introduction Hypophosphataemia is common in critically ill patients, but neither its prevalence nor its association with outcome have been investigated specifically in patients with aneurysmal subarachnoid haemorrhage (aSAH). Methods Patients with aSAH and at least one phosphate measurement were included from two independent cohorts; an American cohort extracted from two open‐access databases (Medical Information Mart for Intensive Care‐III and eICU Collaborative Research Database v. 2.0) and a Danish cohort consisting of patients with aSAH admitted to Rigshospitalet, Denmark over a 4‐year period. In each cohort, we calculated the prevalence of mild (0.32–0.80 mmol/L) and severe (<0.32 mmol/L) hypophosphataemia and their association with in‐hospital mortality before and after propensity‐score matching. Results Hypophosphataemia occurred in 72.4% (95% CI: 68.1–76.3) of patients in the American cohort (n = 471) and 54.9% (50.0–59.7) in the Danish cohort (n = 419). However, it was not associated with mortality in neither full (American: Mild, Odds ratio (OR) 0.99 (0.91–1.07), Severe OR 1.20 (0.95–1.51); Danish: Mild, OR 1.01 (0.95–1.08), Severe OR 1.20 (0.95–1.51)) nor propensity‐score matched cohorts (American (n = 168): Mild, OR 1.06 (0.88–1.28), Severe OR 1.46 (0.96–2.12); Danish (n = 44): Mild, OR 1.16 (0.82–1.65), Severe OR 0.45 (0.13–1.55)). Conclusion In this retrospective study of patients with aSAH, hypophosphataemia was common.

Association of serum phosphate and changes in serum phosphate with 28-day mortality in septic shock from MIMIC-IV database

“…Septic shock is characterized by profound circulatory, cellular, and metabolic abnormalities and is the leading cause of death in hospitals [1][2][3]20 . Numerous studies have revealed that abnormalities in serum phosphate levels are associated with worse outcomes in various diseases [21][22][23][24] . However, the relationship between serum phosphate levels and 28-day mortality in patients with septic shock remains unclear.…”

“…Phosphate is dynamically changing in the body 8,15 . Several studies have identified that changes in serum phosphate levels are predictive factors for adverse outcomes in critically ill patients [21][22][23][24] . Dekker et al found that changes in serum phosphate levels during high-flux hemodialysis or hemodiafiltration are strongly related to the calcification propensity in dialysis patients 40 .…”