PDF(Pubmed)
Abstract：
UNASSIGNED: Hypophosphatemia has been reported to impair diaphragmatic function in patients with chronic obstructive pulmonary disease (COPD). However, little is known about the role of dysphosphatemia at admission [plasmatic phosphate concentration at intensive care unit (ICU) admission (T0-Ph)] to the ICU and respiratory outcomes among patients with severe acute COPD exacerbation. We aimed to assess the value of T0-Ph as a predictive factor of invasive mechanical ventilation (MV) during ICU stay.
UNASSIGNED: We retrospectively included consecutive patients admitted to the ICU for a severe acute exacerbation of COPD between May 2015 and December 2018. Logistic multivariate regression analysis was performed to identify association between T0-Ph and the need for invasive MV during the ICU stay.
UNASSIGNED: We included 198 patients of whom 132 (67%) were male. The median age was 70 [interquartile range (IQR), 61-77] years. Nine (4.5%) patients died in the ICU. Median T0-Ph was significantly higher among patients requiring invasive MV as compared to non-intubated patients [1.23 (IQR, 1.07-1.41) and 1.09 (IQR, 0.91-1.27) mmol/L; P=0.005]. By multivariate analysis, pneumonia [odds ratio (OR) =6.42; 95% confidence interval (CI): 2.78-15.96; P<0.0001) and a history of intubation (OR =3.33; 95% CI: 0.97-11.19; P=0.05) were independently associated with the need for invasive MV, whereas T0-Ph was not (OR =1.75; 95% CI: 0.72-4.44; P=0.22).
UNASSIGNED: T0-Ph was significantly higher in patients requiring invasive MV. However, T0-Ph was not associated with the need for invasive MV in multivariate analysis.
UNASSIGNED: We retrospectively included consecutive patients admitted to the ICU for a severe acute exacerbation of COPD between May 2015 and December 2018. Logistic multivariate regression analysis was performed to identify association between T0-Ph and the need for invasive MV during the ICU stay.
UNASSIGNED: We included 198 patients of whom 132 (67%) were male. The median age was 70 [interquartile range (IQR), 61-77] years. Nine (4.5%) patients died in the ICU. Median T0-Ph was significantly higher among patients requiring invasive MV as compared to non-intubated patients [1.23 (IQR, 1.07-1.41) and 1.09 (IQR, 0.91-1.27) mmol/L; P=0.005]. By multivariate analysis, pneumonia [odds ratio (OR) =6.42; 95% confidence interval (CI): 2.78-15.96; P<0.0001) and a history of intubation (OR =3.33; 95% CI: 0.97-11.19; P=0.05) were independently associated with the need for invasive MV, whereas T0-Ph was not (OR =1.75; 95% CI: 0.72-4.44; P=0.22).
UNASSIGNED: T0-Ph was significantly higher in patients requiring invasive MV. However, T0-Ph was not associated with the need for invasive MV in multivariate analysis.
摘要：
■据报道，低磷酸盐血症会损害慢性阻塞性肺疾病（COPD）患者的膈肌功能。然而,对于重症急性COPD急性加重患者入院时[重症监护病房(ICU)时血浆磷酸盐浓度(T0-Ph)]和呼吸结局的影响知之甚少.我们旨在评估T0-Ph作为ICU住院期间有创机械通气（MV）的预测因素的价值。
我们回顾性纳入了2015年5月至2018年12月因COPD严重急性加重而入院ICU的连续患者。进行Logistic多元回归分析以确定T0-Ph与ICU住院期间侵入性MV需求之间的关联。
■我们纳入了198例患者，其中132例（67%）为男性。中位年龄为70[四分位距（IQR），61-77]年。9名（4.5％）患者在ICU死亡。与未插管的患者相比，需要侵入性MV的患者的T0-Ph中位数明显更高[1.23（IQR，1.07-1.41)和1.09(IQR，0.91-1.27)mmol/L；P=0.005]。通过多变量分析，肺炎[比值比（OR）=6.42;95％置信区间（CI）：2.78-15.96;P<0.0001）和插管史（OR=3.33;95％CI：0.97-11.19;P=0.05）与侵入性MV的需要独立相关，而T0-Ph无差异(OR=1.75;95%CI:0.72-4.44;P=0.22)。
■T0-Ph在需要侵入性MV的患者中明显更高。然而,在多变量分析中，T0-Ph与侵入性MV的需要无关。
我们回顾性纳入了2015年5月至2018年12月因COPD严重急性加重而入院ICU的连续患者。进行Logistic多元回归分析以确定T0-Ph与ICU住院期间侵入性MV需求之间的关联。
■我们纳入了198例患者，其中132例（67%）为男性。中位年龄为70[四分位距（IQR），61-77]年。9名（4.5％）患者在ICU死亡。与未插管的患者相比，需要侵入性MV的患者的T0-Ph中位数明显更高[1.23（IQR，1.07-1.41)和1.09(IQR，0.91-1.27)mmol/L；P=0.005]。通过多变量分析，肺炎[比值比（OR）=6.42;95％置信区间（CI）：2.78-15.96;P<0.0001）和插管史（OR=3.33;95％CI：0.97-11.19;P=0.05）与侵入性MV的需要独立相关，而T0-Ph无差异(OR=1.75;95%CI:0.72-4.44;P=0.22)。
■T0-Ph在需要侵入性MV的患者中明显更高。然而,在多变量分析中，T0-Ph与侵入性MV的需要无关。
