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- Title
Normal-range emergency department serum phosphorus levels and all-cause mortality.
- Authors
Barash, Yiftach; Klang, Eyal; Soffer, Shelly; Zimlichman, Eyal; Leibowitz, Avshalom; Grossman, Ehud; Shlomai, Gadi
- Abstract
<bold>Purpose Of the Study: </bold>Hypophosphataemia and hyperphosphataemia are frequently encountered in hospitalised patients and are associated with significant clinical consequences. However, the prognostic value of normal-range phosphorus levels on all-cause mortality and hospitalisations is not well established. Therefore, we examined the association between normal-range phosphorus levels, all-cause mortality and hospitalisations in patients presenting to the emergency department of a tertiary medical centre in Israel.<bold>Study Design: </bold>A retrospective analysis of patients presenting to the Chaim Sheba Medical Center emergency department between 2012 and 2018. The cohort was divided into quartiles based on emergency department phosphorus levels: 'very-low-normal' (p ≥ 2 mg/dL and p ≤ 2.49 mg/dL), 'low-normal' (p ≥ 2.5 mg/dL and p ≤ 2.99 mg/dL), 'high-normal' (p≥ 3 mg/dL and p≤3.49 mg/dL) and 'very-high-normal' (p ≥ 3.5 mg/dL and p ≤ 4 mg/dL). We analysed the association between emergency department phosphorus levels, hospitalisation rate and 30-day and 90-day all-cause mortality.<bold>Results: </bold>Our final analysis included 223 854 patients with normal-range phosphorus levels. Patients with 'very-low-normal' phosphorus levels had the highest mortality rate. Compared with patients with 'high-normal' phosphorus levels, patients with 'very-low-normal' levels had increased 30-day all-cause mortality (OR 1.3, 95% CI 1.1 to 1.4, p<0.001), and increased 90-day all-cause mortality (OR 1.2, 95% CI 1.1 to 1.3, p<0.001). Lower serum phosphorus levels were also associated with a higher hospitalisation rate, both for the internal medicine and general surgery wards (p<0.001).<bold>Conclusions: </bold>Lower phosphorus levels, within the normal range, are associated with higher 30-day and 90-day all-cause mortality and hospitalisation rate.
- Subjects
HYPERPHOSPHATEMIA; HYPOPHOSPHATEMIA; HOSPITAL emergency services; PHOSPHORUS; LACTATE dehydrogenase
- Publication
Postgraduate Medical Journal, 2021, Vol 97, Issue 1144, p83
- ISSN
0032-5473
- Publication type
journal article
- DOI
10.1136/postgradmedj-2019-137159