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Hyperphosphatemia is associated with high mortality in severe burns
- Source :
- PLoS ONE, PLoS ONE, Vol 13, Iss 1, p e0190978 (2018)
- Publication Year :
- 2018
- Publisher :
- Public Library of Science, 2018.
-
Abstract
- INTRODUCTION Phosphate level is often deranged during acute illness, regardless of the presence of kidney injury or not. A few studies described that hypophosphatemia may associated with outcome in patients admitted to the burn unit, but the literatures for hyperphosphatemia is limited. Our study aims to evaluate if hyperphosphatemia, one of the sign of severe tissue damage or kidney injury, will associate with mortality of patients with severe burns. MATERIALS AND METHODS The study was a post hoc analysis of prospectively collected data from patients admitted to the burn unit between September 2006 and December 2011. Patients were stratified into normophosphatemic or hyperphosphatemic group by baseline plasma phosphate level. The primary endpoint is 90-day mortality. RESULTS Total 301 patients were included (hyperphosphatemia: n = 52; normophosphatemia: n = 249). The hyperphosphatemic group had lower Glasgow Coma Scale, mean arterial blood pressure, hemoglobin level, albumin, and higher TBSA of burns, APACHE II score, ABSI score, Acute kidney injury (AKI), and creatinine. The 90-day mortality was higher in the hyperphosphatemic group than in the normal group (53.8% vs 18.1%, P < .001) and this difference was still significant when adjusting for several confounding factors (hazard ratio, 2.05; 95% CI, 1.17-3.59). Multivariable Cox analysis showed risk factors of mortality included TBSA of burns, hyperphosphatemia, reduced urine output, and APACHE II score. CONCLUSIONS Our study found in addition to TBSA of burns and inhalation injury, baseline hyperphosphatemia in patients with severe burns is also associated with higher mortality.
- Subjects :
- Male
Critical Care and Emergency Medicine
Physiology
lcsh:Medicine
Poison control
Urine
Biochemistry
chemistry.chemical_compound
Hyperphosphatemia
0302 clinical medicine
Medicine and Health Sciences
030212 general & internal medicine
Prospective Studies
lcsh:Science
Prospective cohort study
Trauma Medicine
Burn Management
Multidisciplinary
Respiration
Hazard ratio
Acute kidney injury
Middle Aged
Body Fluids
Chemistry
Inhalation
Creatinine
Physical Sciences
Female
Anatomy
Burns
Traumatic Injury
Hypophosphatemia
Research Article
Adult
medicine.medical_specialty
Death Rates
Dermatology
Phosphates
03 medical and health sciences
Population Metrics
Internal medicine
medicine
Humans
Population Biology
business.industry
lcsh:R
Glasgow Coma Scale
Chemical Compounds
Biology and Life Sciences
030208 emergency & critical care medicine
Kidneys
Renal System
medicine.disease
Survival Analysis
chemistry
lcsh:Q
business
Physiological Processes
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 13
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....6b36cb46c2aa9738af42721cd3db4226