Early Hypophosphatemia as a Prognostic Marker in Acute Pancreatitis

Pancreas. 2024 Aug 1;53(7):e611-e616. doi: 10.1097/MPA.0000000000002344. Epub 2024 May 1.

Abstract

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.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Biomarkers* / blood
  • Female
  • Humans
  • Hypophosphatemia* / blood
  • Hypophosphatemia* / diagnosis
  • Intensive Care Units / statistics & numerical data
  • Length of Stay* / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Pancreatitis* / blood
  • Pancreatitis* / diagnosis
  • Phosphates / blood
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index

Substances

  • Biomarkers
  • Phosphates