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Hyperphosphatemia Is an Independent Risk Factor for Mortality in Critically Ill Patients: Results from a Cross-Sectional Study.

Haider DG, Lindner G, Wolzt M, Ahmad SS, Sauter T, Leichtle AB, Fiedler GM, Fuhrmann V, Exadaktylos AK - PLoS ONE (2015)

Bottom Line: Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died.Hypophosphatemia was not associated with mortality (p>0.05).Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, Switzerland.

ABSTRACT

Background: Phosphate imbalances or disorders have a high risk of morbidity and mortality in patients with chronic kidney disease. It is unknown if this finding extends to mortality in patients presenting at an emergency room with or without normal kidney function.

Methods and patients: This cross sectional analysis included all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland. A multivariable cox regression model was applied to assess the association between phosphate levels and in-hospital mortality up to 28 days.

Results: 22,239 subjects were screened for the study. Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died. In univariate analysis, phosphate levels were associated with mortality, age, diuretic therapy and kidney function (all p<0.001). In a multivariate Cox regression model, hyperphosphatemia (OR 3.29, p<0.001) was a strong independent risk factor for mortality. Hypophosphatemia was not associated with mortality (p>0.05).

Conclusion: Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curve for 28 day in-hospital mortality in patients with hyperphosphatemia (grey line) versus patients with hypophosphatemia (blue line) and patients with normal phosphate levels (green line) (p<0.001).
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pone.0133426.g002: Kaplan-Meier curve for 28 day in-hospital mortality in patients with hyperphosphatemia (grey line) versus patients with hypophosphatemia (blue line) and patients with normal phosphate levels (green line) (p<0.001).

Mentions: The Kaplan Meier curve shows that the increase in mortality in patients with hyperphosphatemia becomes apparent between days 2 and 5 after hospital admission (Fig 2).


Hyperphosphatemia Is an Independent Risk Factor for Mortality in Critically Ill Patients: Results from a Cross-Sectional Study.

Haider DG, Lindner G, Wolzt M, Ahmad SS, Sauter T, Leichtle AB, Fiedler GM, Fuhrmann V, Exadaktylos AK - PLoS ONE (2015)

Kaplan-Meier curve for 28 day in-hospital mortality in patients with hyperphosphatemia (grey line) versus patients with hypophosphatemia (blue line) and patients with normal phosphate levels (green line) (p<0.001).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4529074&req=5

pone.0133426.g002: Kaplan-Meier curve for 28 day in-hospital mortality in patients with hyperphosphatemia (grey line) versus patients with hypophosphatemia (blue line) and patients with normal phosphate levels (green line) (p<0.001).
Mentions: The Kaplan Meier curve shows that the increase in mortality in patients with hyperphosphatemia becomes apparent between days 2 and 5 after hospital admission (Fig 2).

Bottom Line: Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died.Hypophosphatemia was not associated with mortality (p>0.05).Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, Switzerland.

ABSTRACT

Background: Phosphate imbalances or disorders have a high risk of morbidity and mortality in patients with chronic kidney disease. It is unknown if this finding extends to mortality in patients presenting at an emergency room with or without normal kidney function.

Methods and patients: This cross sectional analysis included all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland. A multivariable cox regression model was applied to assess the association between phosphate levels and in-hospital mortality up to 28 days.

Results: 22,239 subjects were screened for the study. Plasma phosphate concentrations were measured in 2,390 patients on hospital admission and were included in the analysis. 3.5% of the 480 patients with hypophosphatemia and 10.7% of the 215 patients with hyperphosphatemia died. In univariate analysis, phosphate levels were associated with mortality, age, diuretic therapy and kidney function (all p<0.001). In a multivariate Cox regression model, hyperphosphatemia (OR 3.29, p<0.001) was a strong independent risk factor for mortality. Hypophosphatemia was not associated with mortality (p>0.05).

Conclusion: Hyperphosphatemia is associated with 28-day in-hospital mortality in an unselected cohort of patients presenting in an emergency room.

No MeSH data available.


Related in: MedlinePlus