Hypophosphatemia associated risk factors in pediatric intensive care patients

Abstract

Şan ES, Erdoğan S, Boşnak M, Şan M. Hypophosphatemia associated risk factors in pediatric intensive care patients. Turk J Pediatr 2017; 59: 35-41. The aim of this work is to determine the prevalence and risk factors of hypophosphatemia in pediatric patients admitted to intensive care unit. The study was performed prospectively in patients admitted to the Pediatric Intensive Care Unit between June 2014 and December 2014. Fifty-seven patients were included in the study. The mean age of the study population was 24 months (2-192 months); 25 patients (43.9%) were male and 32 were female (56.1%). The mean body weight z-score was -1.47 ± 2.23, and 23 (40.4%) patients had malnutrition. On admission 16 (28.1%) patients had hypophosphatemia. There were no statistically significant differences between the hypophosphatemic patient group and normophosphatemic patient groups in terms of demographic and clinical characteristics. There were also no significant differences between the two groups in terms of risk factors. Potassium and creatinine levels were significantly lower in the hypophosphatemic group, compared to the normophosphatemic group. According to a multivariate logistic regression analysis, risk factors for hypophosphatemia were low potassium level (OR: 16.76; 95% CI: 2.09 - 134.72; p: 0.008), malignant solid tumors (OR: 52.40; 95% CI: 2.04 - 1,344.32; p: 0.017, p: 0.036). and female gender (OR: 6.18; 95% CI: 1.12 - 34.00; p: 0.036). Prospective studies with larger sample size should be conducted to study the prevalence and risk factors of hypophosphatemia at pediatric intensive care unit.

Hypophosphatemia in critically ill adults and children – A systematic review

“…Definition of hypophosphatemia in children depends on age [100][101][102][103][104][105][106][107][108][109][110]. In a monocentric retrospective study including 235'980 hospitalized children (6 months to 18 years old), severe hypophosphatemia was defined as a serum Pi 0.38 mmol/l, based on need for transfer to pediatric high-dependency (HDU) or pediatric intensive care units (PICU) as a surrogate for adverse outcome [111].…”

“…In a monocentric retrospective study including 235'980 hospitalized children (6 months to 18 years old), severe hypophosphatemia was defined as a serum Pi 0.38 mmol/l, based on need for transfer to pediatric high-dependency (HDU) or pediatric intensive care units (PICU) as a surrogate for adverse outcome [111]. Based on a more conservative cut-off of 0.8 mmol/l, hypophosphatemia on admission to PICU, would occur in 5% to 50% of admitted patients [100,108,109,[112][113][114], even in countries with low prevalence of malnourished children [115]. Moreover, hypophosphatemia occurs during the first 3 to 7 days in PICU in 30% to 76% of stays [102,104,105,107,113].…”