■在危重病期间,血清磷酸盐水平通常会紊乱。高磷酸盐血症,作为疾病严重程度的标志,吸引了越来越多的关注。本研究旨在评估高磷血症对危重患者临床结局的影响。
■我们在PubMed中搜索了相关研究,EMBASE,和Cochrane数据库截至2022年1月10日。两位作者独立筛选研究,提取的数据,并评估研究质量。进行Meta分析以确定高磷血症的患病率,并评估其与预后和重要临床结局的关系。我们还进行了亚组分析和敏感性分析,以探索异质性的来源。
■有60,358名患者的10项研究符合纳入标准。这些研究是中等到高质量的。高磷血症的患病率中位数为30%(范围为5.6%至45%)。高磷血症患者的全因死亡风险显著高于无(OR2.85;95%CI,2.35~3.38,P<0.0001)。亚组分析,敏感性分析,回归分析进一步证实了这些结果。此外,高磷血症患者需要更多的CRRT(OR4.96;95%CI,2.43至10.2,P<0.0001),但机械通气时间没有显着增加(平均差异,MD0.13,95%CI-0.04至0.30;P=0.138),重症监护病房(ICU)住院时间(SMD0.164天,95%CI-0.007至0.335;P=0.06),和住院时间(SMD0.005天,95%CI-0.74至0.75;P=0.99)。
■我们的结果表明高磷血症与危重患者的全因死亡率相关。然而,由于纳入研究的回顾性设计,更有前瞻性,未来需要精心设计的研究。
■[https://doi.org/10.37766/inplasy2021.12.0130],标识符[INPLASY2021120130]。
UNASSIGNED: Serum phosphate level is often deranged during critical illness.
Hyperphosphatemia, as a marker of disease severity, attracts more and more attention. This study aimed to evaluate the impact of
hyperphosphatemia on clinical outcomes in critically ill patients.
UNASSIGNED: We searched for relevant studies in PubMed, EMBASE, and the Cochrane database up to Jan 10, 2022. Two authors independently screened studies, extracted data, and assessed the study quality. Meta-analyses were performed to determine
hyperphosphatemia prevalence and evaluate its relationship with prognosis and important clinical outcomes. We also conducted subgroup analysis and sensitivity analyses to explore the sources of heterogeneity.
UNASSIGNED: Ten studies with 60,358 patients met the inclusion criteria. These studies were moderate to high quality. The median prevalence of
hyperphosphatemia was 30% (range from 5.6 to 45%). Patients with
hyperphosphatemia had a significantly higher risk of all-cause mortality than those without (OR 2.85; 95% CI, 2.35 to 3.38, P < 0.0001). Subgroup analyses, sensitivity analyses, and regression analyses further confirmed these results. In addition, patients with hyperphosphatemia required more CRRT (OR 4.96; 95% CI, 2.43 to 10.2, P < 0.0001) but not significantly increased duration of mechanical ventilation (mean difference, MD 0.13, 95% CI -0.04 to 0.30; P = 0.138), length of stay in intensive care unit (ICU) (SMD 0.164 day, 95% CI -0.007 to 0.335; P = 0.06), and length of stay in hospital (SMD 0.005 day, 95% CI -0.74 to 0.75; P = 0.99).
UNASSIGNED: Our results indicated that hyperphosphatemia was associated with all-cause mortality in critically ill patients. However, due to the retrospective design of the included studies, more prospective, well-designed research is required in the future.
UNASSIGNED: [https://doi.org/10.37766/inplasy2021.12.0130], identifier [INPLASY2021120130].