Severe Hypophosphatemia in Sepsis as a Mortality Predictor

  1. Julio Weinstein4
  1. 1Departments of Internal Medicine and Metabolic Bone Diseases, 2Biochemistry, 3Statistics, and 4Diabetes, Edith Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  1. Address correspondence to Renana Shor, M.D., Edith Wolfson Medical Center, PO Box 5, Holon, Israel; fax 972 3 502 8382; e-mail: halabe{at}wolfson.health.gov.il.

Abstract

Hypophosphatemia has long been reported to be associated with sepsis and has been correlated with sepsis severity. This retrospective study was undertaken at a university hospital to determine whether severe hypophosphatemia could serve as a mortality predictor in septic patients. Charts of 6,190 septic patients who were hospitalized during one year (2001–02) were examined. Fifty-five patients were selected and were divided into 2 groups: group 1 comprised 26 patients with severe hypophosphatemia (serum inorganic phosphate (Pi) <1 mg/dl); group 2 comprised 29 patients without severe hypophosphatemia (Pi >1 mg/dl. The patients’ charts were reviewed and information was collected regarding medical anamnesis, physical examination, hematological and biochemical analyses, chest x-ray, and cultures of blood and urine. The results demonstrated that 80.8% of the patients with severe hypophosphatemia died, vs 34.5% of the patients without severe hypophosphatemia (p = 0.001). Being in the severe hypophosphatemic group increased the risk of death by nearly 8-fold (odds ratio = 7.98; 95% CI = 2.3 to 27.6). These findings indicate that severe hypophosphatemia can serve as an independent mortality predictor in sepsis.

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