Related Experiment Video
Updated: Jun 27, 2025
Preparing a Mice Model of Severe Acute Pancreatitis via a Combination of Caerulein and Lipopolysaccharide Intraperitoneal Injection
Published on: May 10, 2024
Early Hypophosphatemia as a Prognostic Marker in Acute Pancreatitis
Connor F Stewart1, Esther A Adeniran1, Dhiraj Yadav2
1From the Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA.
Insights
Hypophosphatemia, or low serum phosphate, is an infrequent marker in acute pancreatitis (AP) patients. This condition is associated with increased ICU admission, longer hospital stays, and severe AP, indicating its prognostic value.
Area of Science:
- Gastroenterology and Hepatology
- Critical Care Medicine
- Clinical Chemistry
Background:
- Acute pancreatitis (AP) is a significant cause of hospitalization, necessitating identification of prognostic markers.
- Understanding AP risk factors can lead to targeted therapeutic interventions.
- Hypophosphatemia is a potential, yet under-evaluated, prognostic indicator in AP.
Purpose of the Study:
- To investigate the association between hypophosphatemia and clinical outcomes in patients with acute pancreatitis.
- To determine if serum phosphate levels measured early in hospitalization can predict AP severity, ICU admission, and length of stay.
Main Methods:
- Retrospective review of electronic health records for 1526 AP patients admitted between 2012 and 2021.
- Serum phosphate levels were analyzed within 48 hours of admission.
- Multivariable logistic and log-linear regression models were used to assess correlations with ICU admission, AP severity, and length of stay.
Main Results:
- Only 33% of AP patients had serum phosphate measured within 48 hours of admission.
- Hypophosphatemia was significantly associated with higher odds of ICU admission (AOR=4.57) and moderate-to-severe AP (AOR=1.80).
- Patients with hypophosphatemia experienced a longer length of stay (log-LOS=0.34).
Conclusions:
- Serum phosphate measurement is not routinely performed in AP patients.
- Early hypophosphatemia shows significant promise as a prognostic marker for adverse outcomes in acute pancreatitis.
- Further research is warranted to explore the clinical utility of monitoring serum phosphate in AP management.
Objectives:
Acute pancreatitis (AP) is a complex disease representing a significant portion of gastrointestinal-related hospitalizations in the U.S. Understanding risk factors of AP might provide attractive therapeutic targets. We evaluated hypophosphatemia a prognostic marker in AP.
Methods:
We performed a retrospective review of electronic health records of patients with AP from 01/ 01/2012-12/31/2021 at Cedars-Sinai Medical Center with serum phosphate measured within 48 hours of admission. Multivariable logistic regression modeling was used to evaluate associations with ICU admission and AP severity. Multivariable log-linear modeling was employed to examine associations with length of stay (LOS).
Results:
Of 1526 patients admitted for AP, 33% (499) had a serum phosphate level measured within 48 hours. Patients with hypophosphatemia were more likely to have ICU admission (adjusted odds ratio (AOR) = 4.57; 95% confidence interval (CI): 2.75-7.62; P < 0.001), have a longer hospital stay (log-LOS = 0.34; SE; 0.09; 95% CI: 0.17-0.52; P < 0.001), and have moderate or severe AP (AOR = 1.80; 95% CI: 1.16-2.80; P < 0.001) compared with those without hypophosphatemia.
Conclusion:
Serum phosphate is infrequently measured in patients with AP and shows promise as an early prognostic marker for outcomes of AP.
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:15Hypoglycemia and Glucagon
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...