Levels of serum phosphate among critically ill patients, its predictors and prognostic significance: A hospital based observational study

Abstract

Objectives: The objective was to estimate the prevalence of hypo- and hyperphosphatemia in a cohort of critically ill patients admitted to the ICU. Additionally, the study explores factors associated with these disturbances in phosphate levels and assesses their prognostic significance in terms of patient outcomes and mortality rates. Methods: This was a single centre hospital based non-randomised prospective observational study conducted among critically ill patients (14 and 60 years of age) admitted to the intensive care unit (ICU), Department of General Medicine of the tertiary healthcare facility in south India between January 2019 and October 2019. Results: The present study enrolled a total of 200 critically ill patients. It was found that 22.0% of patients had hyperphosphatemia and 8.0% had hypophosphatemia. Age >30 years, hypertension, chronic obstructive pulmonary disease, liver disease, chronic kidney disease, use of alcohol, and tobacco were significant predictors of hypophosphatemia among critically ill patients (p<0.05). Patients with hypocalcaemia were at increased risk of hypophosphatemia. Majority (93.8%) of the patients with hypophosphatemia required mechanical ventilation. The mortality rate in the present study was 28.0% – 16.1% were among patients with hypophosphatemia and 32.1% among patients with hyperphosphatemia (p<0.05). Conclusion: Recognizing the risk factors associated with abnormal phosphate levels and understanding their clinical consequences can aid in timely intervention and improved patient care.