Epidemiology of hypophosphatemia in critical illness: A multicentre, retrospective cohort study
Authors' conclusion
Hypophosphatemia was common, and mostly occurred on day 2 with early correction of serum phosphate. Phosphate replacement practices were variable among ICUs. Moderate and severe hypophosphatemia was associated with increased 90-day case fatality.
Study context
- Population
- Adults admitted to 12 ICUs in Queensland, Australia, 2015–2021, excluding readmissions, RRT, end-stage renal disease, palliative intent and inter-ICU transfersof 89,776 admitted
- Participants
- 68,699 adults
- Exposure
- Mild, moderate or severe hypophosphatemia vs none
- Outcome
- 90-day case fatality
- Follow-up
- Day 90
Methodological detailsmulticentre, mixed-effect logistic regression
- Multicentre
- Mixed-effect logistic regression
Main finding
As reported in the abstract
Day-90 case fatality
Each group vs noneOdds ratio (95% CI)P value
Moderate
1.24(1.07–1.44)
P = 0.004Severe
1.49(1.13–1.97)
P = 0.005- Case fatality increased with severity of hypophosphatemia
- P < 0.001
Observational data: associations, not effects.
Further findings
Incidence of hypophosphatemia
- Hypophosphatemia
- 23,485 (34.2%)
- Onset mostly on Day 2 of ICU admission; corrected to normal 3 days after identification
Phosphate replacement practice
- Substantial variation among ICUs in threshold and route of replacement
Original publication
Epidemiology of hypophosphatemia in critical illness: A multicentre, retrospective cohort study. Anaesth Crit Care Pain Med. Published 30 July 2024. doi:10.
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