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Serum Phosphate is a Biomarker for In-hospital and 30-day Mortality in Patients With Acute Pancreatitis Based on the
Kun Li1, Shuo Cao2, Kexiang Qin3
1Department of Chinese and Western Integrative Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China.
Background:
Acute pancreatitis (AP) is the most common disease in emergency and intensive care units; early mortality predictions and intervention are crucial for improving patient prognosis. We investigated the association of serum phosphate with mortality among AP patients using a large public database.
Methods:
This was a retrospective study. All AP patients in the MIMIC-IV database were included. Based on the tertiles of serum phosphate, all AP patients were divided into 3 groups. Two generalized additive models were performed to explore the association of serum phosphate with in-hospital and 30-day mortality. Kaplan-Meier analysis was introduced for survival probability.
Results:
A total of 1088 AP patients admitted to the ICU were included. The mortalities of in-hospital (n=137) and 30-day (n=118) were 12.59% and 10.85%, respectively. The median levels of serum phosphate in the survivor and the non-survivor groups were 3.20 and 3.90 mg/dL, respectively (P<0.001). After adjusting for all potential confounders, with 1 mg/dL increment in serum phosphate, the risk of in-hospital and 30-day mortality increased by 20% (HR=1.20, 95% CI: 1.00-1.44, P=0.0443) and 25% (HR=1.25, 95% CI: 1.03-1.52, P=0.0214), respectively. The areas under the ROC curve (AUC) of serum phosphate for predicting in-hospital and 30-day mortality were 0.650 (95% CI: 0.599-0.701) and 0.659 (95% CI: 0.605-0.714), respectively. The cutoff values of serum phosphate were 3.65 and 4.35 mg/dL, respectively.
Conclusions:
A linear positive relationship was found between serum phosphate and in-hospital and 30-day mortality in AP. Serum phosphate was associated with in-hospital and 30-day mortality in AP. Our results could be used for screening out those AP patients with a higher risk of worse outcomes.
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