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Abstract: PO1476

Hospital-Acquired Phosphate Derangements and Associated In-Hospital Mortality

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

  • 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Mao, Michael A., Mayo Clinic's Campus in Florida, Jacksonville, Florida, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Chewcharat, Api, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kashani, Kianoush, Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

We aimed to report the incidence of hospital-acquired hypophosphatemia and hyperphosphatemia along with their associated in-hospital mortality.

Methods

We included 15,869 adult patients hospitalized at a tertiary medical referral center from January 2009 to December 2013 that had normal serum phosphate levels at admission and at least two serum phosphate measurements during their hospitalization. The normal range of serum phosphate was defined as 2.5-4.2 mg/dL. In-hospital serum phosphate levels were categorized based on the occurrence of hospital-acquired hypophosphatemia and hyperphosphatemia. We analyzed the association of hospital-acquired hypophosphatemia and hyperphosphatemia with in-hospital mortality using multivariable logistic regression.

Results

Fifty-four percent of patients developed new serum phosphate derangements during their hospitalization. The incidence of hospital-acquired hypophosphatemia and hyperphosphatemia was 35% and 27%, respectively. Hospital-acquired hypophosphatemia and hyperphosphatemia were associated with odds of 1.56 and 2.60 for in-hospital mortality, respectively (P-value<0.001 for both). Compared with patients with persistently normal in-hospital phosphate levels, patients with hospital-acquired hypophosphatemia only (OR 1.64), hospital-acquired hyperphosphatemia only (OR 2.74), and both hospital-acquired hypophosphatemia and hyperphosphatemia (i.e., phosphate fluctuations; OR 4.00) were significantly associated with increased in-hospital mortality (all p-value<0.001).

Conclusion

Hospital-acquired serum phosphate derangements affect approximately half of hospitalized patients and are associated with increased in-hospital mortality rate.

Association between hospital-acquired serum phosphate derangements and in-hospital mortality