Association between serum phosphate and in-hospital mortality of patients with AECOPD: A retrospective analysis on eICU database

Li, Siqi; Huang, Qiong; Nan, Wenbin; He, Baimei

doi:10.1016/j.heliyon.2023.e19748

Cited by 2 publications

(2 citation statements)

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“… 7 , 25 Very few epidemiological studies have explored an association between serum phosphate and COPD, previous similar study has shown that comprehensive retrospective analysis involving 1199 hospitalized patients revealed a positive association between elevated serum phosphate levels and increased in-hospital mortality among individuals diagnosed with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). 18 Our study results were consistent with this, showing that for each 1 mg/dL increase in serum phosphorus, in-hospital mortality increases by 19%, and 90-day mortality increases by 15%. Upon categorizing serum phosphorus levels, we observed that the high serum phosphorus group, when compared to the second quartile, was associated with a higher risk for in-hospital mortality (HR 1.47, 95% CI 1.08–2) and mortality within 90 days (HR 1.31, 95% CI 1.06–1.61).…”

Section: Discussionsupporting

confidence: 92%

“…15 A few studies have indicated a relation between the severity and prognosis of COPD and the serum phosphate level. 16–18 For instance, In the study conducted by Li et al, 18 a positive relationship was observed between elevated serum phosphate levels and a higher risk of in-hospital mortality among patients experiencing acute exacerbation of AECOPD. In individuals with severe COPD, the serum phosphate level may act as an indicator of the severity of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Association Between the Serum Phosphate Levels and Hospital Mortality as Well as 90-Day Mortality Among Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

Du,

Lin,

et al. 2024

COPD

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Purpose COPD patients frequently have abnormal serum phosphorus levels. The objective of this study was to examine the correlation between serum phosphorus levels with hospital and 90-day mortality in critically ill patients with COPD. Patients and Methods The MIMIC IV database was used for this retrospective cohort analysis. We extracted demographics, vital signs, laboratory tests, comorbidity, antibiotic usage, ventilation and scoring systems within the first 24 hours of ICU admission. Restricted cubic splines and multivariate cox regression analysis models were used to evaluate the connection between serum phosphorus with hospital and 90-day mortality. We assessed and classified various factors including gender, age, renal disease, severe liver disease, the utilization of antibiotics and congestive heart failure. Results We included a total of 3611 patients with COPD, with a median age of 70.7 years. After adjusting for all other factors, we observed a significant positive association between serum phosphate levels with both hospital mortality (HR 1.19, 95% CI: 1.07–1.31, p<0.001) and 90-day mortality (HR 1.15, 95% CI: 1.06–1.24, p<0.001). Compared to the medium group (Q2 ≥3.15, <4.0), the adjusted hazard ratios for hospital mortality were 1.47 (95% CI: 1.08–2, p=0.013), and 1.31 (95% CI: 1.06–1.61, p=0.013) for 90-day mortality in the high group (Q3≥4.0). Hospital mortality decreased at serum phosphate levels below 3.8 mg/dl (HR 0.664, 95% CI: 0.468–0.943, p=0.022), but increased for both hospital (HR 1.312, 95% CI: 1.141–1.509, p<0.001) and 90-day mortality (HR 1.236, 95% CI: 1.102–1.386, p<0.001) when levels were above 3.8 mg/dl. Subgroup and sensitivity analyses yielded consistent results. Conclusion In critical ill COPD patients, this study demonstrated a non-linear association between serum phosphate levels and both hospital and 90-day mortality. Notably, there was an inflection point at 3.8 mg/dl, indicating a significant shift in outcomes. Future prospective research is necessary to validate this correlation.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Association Between the Serum Phosphate Levels and Hospital Mortality as Well as 90-Day Mortality Among Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

Du,

Lin,

et al. 2024

COPD

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An integrated metabo-lipidomics profile of induced sputum for the identification of novel biomarkers in the differential diagnosis of asthma and COPD

Correnti,

Preianò,

Gamboni

et al. 2024

J Transl Med

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Background Due to their complexity and to the presence of common clinical features, differentiation between asthma and chronic obstructive pulmonary disease (COPD) can be a challenging task, complicated in such cases also by asthma–COPD overlap syndrome. The distinct immune/inflammatory and structural substrates of COPD and asthma are responsible for significant differences in the responses to standard pharmacologic treatments. Therefore, an accurate diagnosis is of central relevance to assure the appropriate therapeutic intervention in order to achieve safe and effective patient care. Induced sputum (IS) accurately mirrors inflammation in the airways, providing a more direct picture of lung cell metabolism in comparison to those specimen that reflect analytes in the systemic circulation. Methods An integrated untargeted metabolomics and lipidomics analysis was performed in IS of asthmatic (n = 15) and COPD (n = 22) patients based on Ultra-High-Pressure Liquid Chromatography-Mass Spectrometry (UHPLC-MS) and UHPLC–tandem MS (UHPLC-MS/MS). Partial Least Squares-Discriminant Analysis (PLS-DA) was applied to resulting dataset. The analysis of main enriched metabolic pathways and the association of the preliminary metabolites/lipids pattern identified to clinical parameters of asthma/COPD differentiation were explored. Multivariate ROC analysis was performed in order to determine the discriminatory power and the reliability of the putative biomarkers for diagnosis between COPD and asthma. Results PLS-DA indicated a clear separation between COPD and asthmatic patients. Among the 15 selected candidate biomarkers based on Variable Importance in Projection scores, putrescine showed the highest score. A differential IS bio-signature of 22 metabolites and lipids was found, which showed statistically significant variations between asthma and COPD. Of these 22 compounds, 18 were decreased and 4 increased in COPD compared to asthmatic patients. The IS levels of Phosphatidylethanolamine (PE) (34:1), Phosphatidylglycerol (PG) (18:1;18:2) and spermine were significantly higher in asthmatic subjects compared to COPD. Conclusions This is the first pilot study to analyse the IS metabolomics/lipidomics signatures relevant in discriminating asthma vs COPD. The role of polyamines, of 6-Hydroxykynurenic acid and of d-rhamnose as well as of other important players related to the alteration of glycerophospholipid, aminoacid/biotin and energy metabolism provided the construction of a diagnostic model that, if validated on a larger prospective cohort, might be used to rapidly and accurately discriminate asthma from COPD. Graphical Abstract

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Association between serum phosphate and in-hospital mortality of patients with AECOPD: A retrospective analysis on eICU database

Cited by 2 publications

References 56 publications

Association Between the Serum Phosphate Levels and Hospital Mortality as Well as 90-Day Mortality Among Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

Association Between the Serum Phosphate Levels and Hospital Mortality as Well as 90-Day Mortality Among Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

An integrated metabo-lipidomics profile of induced sputum for the identification of novel biomarkers in the differential diagnosis of asthma and COPD

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