DOI: https://doi.org/10.22263/2312-4156.2023.2.54
I.H. Halubtsou1, V.A. Dudko1,2, A.V. Marochkov1,2, A.L. Lipnitski1,2, S.A. Tachyla1,2
Hypophosphatemia and treatment outcomes of patients in the department of anesthesiology and resuscitation of a multidisciplinary hospital
1Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2023;22(2):54-61.
Abstract.
Objectives. To determine the effect of hypophosphatemia on the results of treatment of patients in the intensive care unit (ICU) of a multidisciplinary hospital.
Material and methods. A single-center retrospective non-randomized observational study was conducted. Out of 8595 multidisciplinary hospital patients, 306 were diagnosed with hypophosphatemia in terms of phosphorus levels, i.e. the phosphorus content in their serum was below 0.81 mmol/L. As the endpoints of the research, the following ones were selected: 1) the duration of treatment in the hospital; 2) the duration of treatment in the ICU; 3) the outcomes of treatment. All serum phosphorus levels refer to the initial measurement of phosphorus upon the arrival at the ICU. We limited our study to patients with phosphorus levels from 0 – 0.8 mmol/L (hypophosphatemia). All patients were divided into 3 groups depending on the level of hypophosphatemia: group 1 (mild) – 0.65-0.8 mmol/L; group 2 (moderate) – 0.32-0.64 mmol/L; group 3 (severe) – 0-0.31 mmol/L. The obtained data were statistically processed using nonparametric analysis methods.
Results. After analyzing the data, it was found that the incidence of hypophosphatemia in a multidisciplinary hospital made up 306 patients out of 8595, which was 3.56%. The duration of treatment of patients in ICU was statistically significantly longer in the deceased patients – 9 (3; 17) days than in the survived patients – 2 (0; 5) days (p<0.0001). The level of hypophosphatemia in patients with an unfavorable outcome was lower – 0.57 (0.42, 0.71) mmol/L than in patients with a positive outcome of the disease – 0.67 (0.59; 0.74) mmol/L (p<0.0001). Mortality rate in patients with severe hypophosphatemia in group 3 with a phosphorus level of 0-0.4 mmol/L was statistically significantly higher (41.7%) than in patients with mild hypophosphatemia in group 1 (10.4%) with a phosphorus level of 0.65-0.8 mmol/L (p<0.0001).
Conclusions. Taking into account such results, we consider it necessary to carry out mandatory correction of hypophosphatemia in patients being treated in the ICU.
Keywords: hypophosphatemia, phosphates, inorganic phosphorus, mortality.
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Information about authors:
I.H. Halubtsou – anesthesiologist-resuscitator of the anesthesiology and resuscitation department of the Cardiovascular Surgery Center, Mogilev Regional Clinical Hospital, https://orcid.org/0000-0002-0744-1867
V.A. Dudko – anesthesiologist-resuscitator, head of the anesthesiology and resuscitation department of the Cardiovascular Surgery Center, Mogilev Regional Clinical Hospital; senior lecturer of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-5959-5454
A.V. Marochkov – Doctor of Medical Sciences, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-5092-8315
A.L. Lipnitski – Candidate of Medical Sciences, anesthesiologist-resuscitator, head of the department for taking organs and tissues for transplantation, Mogilev Regional Clinical Hospital; associate professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-2556-4801
S.A. Tachyla – Candidate of Medical Sciences, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; associate professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0003-1659-5902
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