PDF(Pubmed)
Abstract：
UNASSIGNED: COPD patients frequently have abnormal serum phosphorus levels. The objective of this study was to examine the correlation between serum phosphorus levels with hospital and 90-day mortality in critically ill patients with COPD.
UNASSIGNED: The MIMIC IV database was used for this retrospective cohort analysis. We extracted demographics, vital signs, laboratory tests, comorbidity, antibiotic usage, ventilation and scoring systems within the first 24 hours of ICU admission. Restricted cubic splines and multivariate cox regression analysis models were used to evaluate the connection between serum phosphorus with hospital and 90-day mortality. We assessed and classified various factors including gender, age, renal disease, severe liver disease, the utilization of antibiotics and congestive heart failure.
UNASSIGNED: We included a total of 3611 patients with COPD, with a median age of 70.7 years. After adjusting for all other factors, we observed a significant positive association between serum phosphate levels with both hospital mortality (HR 1.19, 95% CI: 1.07-1.31, p<0.001) and 90-day mortality (HR 1.15, 95% CI: 1.06-1.24, p<0.001). Compared to the medium group (Q2 ≥3.15, <4.0), the adjusted hazard ratios for hospital mortality were 1.47 (95% CI: 1.08-2, p=0.013), and 1.31 (95% CI: 1.06-1.61, p=0.013) for 90-day mortality in the high group (Q3≥4.0). Hospital mortality decreased at serum phosphate levels below 3.8 mg/dl (HR 0.664, 95% CI: 0.468-0.943, p=0.022), but increased for both hospital (HR 1.312, 95% CI: 1.141-1.509, p<0.001) and 90-day mortality (HR 1.236, 95% CI: 1.102-1.386, p<0.001) when levels were above 3.8 mg/dl. Subgroup and sensitivity analyses yielded consistent results.
UNASSIGNED: In critical ill COPD patients, this study demonstrated a non-linear association between serum phosphate levels and both hospital and 90-day mortality. Notably, there was an inflection point at 3.8 mg/dl, indicating a significant shift in outcomes. Future prospective research is necessary to validate this correlation.
UNASSIGNED: The MIMIC IV database was used for this retrospective cohort analysis. We extracted demographics, vital signs, laboratory tests, comorbidity, antibiotic usage, ventilation and scoring systems within the first 24 hours of ICU admission. Restricted cubic splines and multivariate cox regression analysis models were used to evaluate the connection between serum phosphorus with hospital and 90-day mortality. We assessed and classified various factors including gender, age, renal disease, severe liver disease, the utilization of antibiotics and congestive heart failure.
UNASSIGNED: We included a total of 3611 patients with COPD, with a median age of 70.7 years. After adjusting for all other factors, we observed a significant positive association between serum phosphate levels with both hospital mortality (HR 1.19, 95% CI: 1.07-1.31, p<0.001) and 90-day mortality (HR 1.15, 95% CI: 1.06-1.24, p<0.001). Compared to the medium group (Q2 ≥3.15, <4.0), the adjusted hazard ratios for hospital mortality were 1.47 (95% CI: 1.08-2, p=0.013), and 1.31 (95% CI: 1.06-1.61, p=0.013) for 90-day mortality in the high group (Q3≥4.0). Hospital mortality decreased at serum phosphate levels below 3.8 mg/dl (HR 0.664, 95% CI: 0.468-0.943, p=0.022), but increased for both hospital (HR 1.312, 95% CI: 1.141-1.509, p<0.001) and 90-day mortality (HR 1.236, 95% CI: 1.102-1.386, p<0.001) when levels were above 3.8 mg/dl. Subgroup and sensitivity analyses yielded consistent results.
UNASSIGNED: In critical ill COPD patients, this study demonstrated a non-linear association between serum phosphate levels and both hospital and 90-day mortality. Notably, there was an inflection point at 3.8 mg/dl, indicating a significant shift in outcomes. Future prospective research is necessary to validate this correlation.
摘要：
■COPD患者经常有异常的血清磷水平。这项研究的目的是检查COPD危重患者的血清磷水平与医院和90天死亡率之间的相关性。
■本回顾性队列分析使用MIMICIV数据库。我们提取了人口统计数据，生命体征,实验室测试,合并症，抗生素的使用，ICU入院后24小时内的通气和评分系统。使用限制性三次样条和多变量cox回归分析模型来评估血清磷与住院和90天死亡率之间的关系。我们对各种因素进行了评估和分类，包括性别，年龄,肾脏疾病,严重的肝脏疾病,抗生素的使用和充血性心力衰竭。
■我们共纳入了3611例COPD患者，平均年龄为70.7岁。在调整了所有其他因素后，我们观察到血清磷酸盐水平与住院死亡率(HR1.19,95%CI:1.07~1.31,p<0.001)和90天死亡率(HR1.15,95%CI:1.06~1.24,p<0.001)之间存在显著正相关.与中等组相比（Q2≥3.15，<4.0），调整后的住院死亡率风险比为1.47（95％CI：1.08-2，p=0.013），高组（Q3≥4.0）的90天死亡率为1.31（95％CI：1.06-1.61，p=0.013）。血清磷酸盐水平低于3.8mg/dl时，医院死亡率降低（HR0.664，95％CI：0.468-0.943，p=0.022），但是当水平高于3.8mg/dl时，医院（HR1.312，95％CI：1.141-1.509，p<0.001）和90天死亡率（HR1.236，95％CI：1.102-1.386，p<0.001）均增加。亚组和敏感性分析产生一致的结果。
■在重症COPD患者中，这项研究表明,血清磷酸盐水平与住院死亡率和90日死亡率之间存在非线性关联.值得注意的是,有一个拐点在3.8毫克/分升，表明结果发生了重大变化。未来的前瞻性研究有必要验证这种相关性。
■本回顾性队列分析使用MIMICIV数据库。我们提取了人口统计数据，生命体征,实验室测试,合并症，抗生素的使用，ICU入院后24小时内的通气和评分系统。使用限制性三次样条和多变量cox回归分析模型来评估血清磷与住院和90天死亡率之间的关系。我们对各种因素进行了评估和分类，包括性别，年龄,肾脏疾病,严重的肝脏疾病,抗生素的使用和充血性心力衰竭。
■我们共纳入了3611例COPD患者，平均年龄为70.7岁。在调整了所有其他因素后，我们观察到血清磷酸盐水平与住院死亡率(HR1.19,95%CI:1.07~1.31,p<0.001)和90天死亡率(HR1.15,95%CI:1.06~1.24,p<0.001)之间存在显著正相关.与中等组相比（Q2≥3.15，<4.0），调整后的住院死亡率风险比为1.47（95％CI：1.08-2，p=0.013），高组（Q3≥4.0）的90天死亡率为1.31（95％CI：1.06-1.61，p=0.013）。血清磷酸盐水平低于3.8mg/dl时，医院死亡率降低（HR0.664，95％CI：0.468-0.943，p=0.022），但是当水平高于3.8mg/dl时，医院（HR1.312，95％CI：1.141-1.509，p<0.001）和90天死亡率（HR1.236，95％CI：1.102-1.386，p<0.001）均增加。亚组和敏感性分析产生一致的结果。
■在重症COPD患者中，这项研究表明,血清磷酸盐水平与住院死亡率和90日死亡率之间存在非线性关联.值得注意的是,有一个拐点在3.8毫克/分升，表明结果发生了重大变化。未来的前瞻性研究有必要验证这种相关性。
