Serum inorganic phosphorus levels predict 30-day mortality in patients with community acquired pneumonia

Abstract

BackgroundCommunity acquired pneumonia is a major cause of morbidity and mortality. The association between serum phosphorus levels on admission and the outcome of patients with community acquired pneumonia has not been widely examined. We aimed to investigate the prognostic value of serum phosphorus levels on admission on the 30- day mortality.MethodsThe cohort included patients of 18 years old or older who were diagnosed with community acquired pneumonia between 2006 and 2012. Patients were retrospectively analyzed to identify risk factors for a primary endpoint of 30-day mortality. Binary logistic regression analysis was used for the calculation of the odds ratios (OR) and p values in bivariate and multivariate analysis to identify association between patients’ characteristic and 30-day mortality.ResultsThe cohort included 3894 patients. In multivariate regression analysis, variables associated with increased risk of 30-day mortality included: age >80 years, increased CURB-65 score, RDW >15, hypernatremia >150 mmol/l, hypoalbuminemia <2 gr/dl and abnormal levels of phosphorus. Levels of <1.5 mg/dl and >4.5 mg/dl were significantly associated with excess 30-day mortality, 38 % (OR 2.9, CI 1.8-4.9, P = 0.001) and 39 % (OR 3.4, CI 2.7-4.2, P = 0.001), respectively. Phosphorus levels within the upper normal limits (4-4.5 mg/dl) were associated with higher mortality rates compared to levels between 1.5-3.5 mg/dl, the reference group, 24 % (OR 1.9, CI 1.5-2.4, P = 0.001).ConclusionsAbnormal phosphorus levels on admission are associated with increased mortality rates among patients hospitalized with Community acquired pneumonia.

Early hypophosphatemia in very low birth weight preterm infants

“…Transient hypophosphatemia is also observed in both children and adults in the course of diagnosed infections; phosphorus concentration is inversely proportionate to C-reactive protein (CRP) level, so other anti-inflammatory factors are said to take part in the process (tumor necrosis factor alpha and interleukin 6). 22,23 When should phosphorus concentration be monitored, then? Unfortunately, there are no generally accepted protocols, but there is increasing evidence which indicates that it is important to measure phosphate concentration within the first days of life.…”

<p>Age, Pulse, Urea and Albumin (APUA) Model: A Tool for Predicting in-Hospital Mortality of Community-Acquired Pneumonia Adapted for Patients with Type 2 Diabetes</p>

“…Numerous studies confirmed that serum albumin correlated with short-term and long-term mortality of CAP. [14][15][16][17] In the CAP-China network, albumin level was also an independent predictor of 60-day mortality of CAP. 18 Serum albumin is closely related to the risk of death in T2DM.…”

Is&nbsp;Monitoring for Phosphate&nbsp;a Necessary Measure in Critical Ill Patients ?

“…For hyperphosphatemia, most studies had proved that hyperphosphatemia was an independent risk factor for mortality or morbidity [1,7,11,14,15,[20][21][22][23][24][25][26]. For hypophosphatemia, some studies showed that it was an independent risk factor for mortality or morbidity [1,8,23,27], but some studies showed that it was not signi cantly associated with mortality or morbidity [15,20,22,28]. Thus, it was not determined whether serum phosphate abnormalities are directly related to the increase in mortality in ICU patients or merely a sign of the severity of disease for ICU patients.…”