ArticleBMJ open2021
Association between serum phosphate and mortality in critically ill patients: a large retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Association between blood phosphorus level and clinical outcomes in critically ill patients: A systematic review and meta-analysis.JPEN. Journal of parenteral and enteral nutrition · 2026Pooled it
- Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Prognostic Analysis of ICU Patients with Chronic Obstructive Pulmonary Disease Based on Blood Phosphate Dynamics: A Retrospective Cohort Study from the MIMIC-IV Database.International journal of chronic obstructive pulmonary disease · 2026Article
- Association between serum phosphate levels and outcome among critically ill newborns: a retrospective cohort study.Frontiers in pediatrics · 2026Article
- Electrolyte disorders in the critically ill: a retrospective analysis.Scientific reports · 2025Article
- The association between serum phosphate and length of hospital stay and all-cause mortality in adult patients: a cross-sectional study.Nutrition journal · 2024Article
- Association Between the Serum Phosphate Levels and Hospital Mortality as Well as 90-Day Mortality Among Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study.International journal of chronic obstructive pulmonary disease · 2024Article
- Article
- Elevated Initial Serum Phosphate Levels Predict Higher Mortality and Impaired Neurological Outcome in Cardiac Arrest Patients with Return of Spontaneous Circulation.Diagnostics (Basel, Switzerland) · 2023Article
- Relationship between serum phosphate and mortality in critically ill children receiving continuous renal replacement therapy.Frontiers in pediatrics · 2023Article
- A non-linear positive relationship between serum phosphate and clinical outcomes in sepsis.Heliyon · 2022Article
- Membrane lipid renovation in Pseudomonas aeruginosa - implications for phage therapy?Environmental microbiology · 2022Review
- Day-Specific Associations of Serum Phosphate With 90-Day Mortality in Adult Patients With sepsis: A Landmark Analysis.Acute medicine & surgeryArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis research aims to explore the impact of serum phosphate on the mortality of critically ill patients.
designA retrospective large cohort study.
settingOur data were extracted from a publicly accessible database named 'Multiparameter Intelligent Monitoring in Intensive Care Database III'.
participants27 131 patients were included by clear definitions of selection and exclusion criteria.
interventionsWe used initial phosphate at admission as a design variable. Patients were divided into six groups with different serum phosphate levels and five groups at different intensive care unit (ICU) departments. PRIMARY AND SECONDARY OUTCOMES: 28-day and 90-day mortality were primary outcomes. All-cause mortality and length of stay ICU were secondary outcomes.
resultsPatients with very-high-normal serum phosphate, hypophosphataemia and hyperphosphataemia had worse outcomes. And the relationship between serum phosphate and the probability of 28-day or 90-day mortality had a linear relationship. After adjustment for potential confounders, hypophosphataemia and hyperphosphataemia were not significantly associated with 28-day or 90-day mortality. Nevertheless, at the medical ICU, hyperphosphataemia was associated with increased 28-day or 90-day mortality (HR=0.64, 95% CI 0.48 to 0.84, p=0.0017; HR=0.72, 95% CI 0.57 to 0.91, p=0.0067, respectively), using group 2 (≥2.5 mg/dL and <3.0 mg/dL) as the reference group.
conclusionsPatients with very-high-normal serum phosphate also had worse outcomes, it might be necessary to re-evaluate the definitions of the normal reference range for serum phosphate. Hypophosphataemia and hyperphosphataemia are not the independent risk factors of 28-day or 90-day ICU mortality, which leads us to consider whether phosphate monitoring is not a necessary measure in critically ill patients. But hyperphosphataemia was associated with increased 28-day or 90-day mortality at the medical ICU, which emphasises the potential importance of early diagnosis and treatment of hyperphosphataemia for the patients who were admitted to the medical ICU.
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