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Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis

INTRODUCTION: 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. METHODS: We searched for...

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Autores principales: Zheng, Wen-He, Yao, Yan, Zhou, Hua, Xu, Yuan, Huang, Hui-Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9156794/
https://www.ncbi.nlm.nih.gov/pubmed/35665344
http://dx.doi.org/10.3389/fmed.2022.870637
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author Zheng, Wen-He
Yao, Yan
Zhou, Hua
Xu, Yuan
Huang, Hui-Bin
author_facet Zheng, Wen-He
Yao, Yan
Zhou, Hua
Xu, Yuan
Huang, Hui-Bin
author_sort Zheng, Wen-He
collection PubMed
description INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. SYSTEMATIC REVIEW REGISTRATION: [https://doi.org/10.37766/inplasy2021.12.0130], identifier [INPLASY2021120130].
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spelling pubmed-91567942022-06-02 Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis Zheng, Wen-He Yao, Yan Zhou, Hua Xu, Yuan Huang, Hui-Bin Front Med (Lausanne) Medicine INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. SYSTEMATIC REVIEW REGISTRATION: [https://doi.org/10.37766/inplasy2021.12.0130], identifier [INPLASY2021120130]. Frontiers Media S.A. 2022-05-17 /pmc/articles/PMC9156794/ /pubmed/35665344 http://dx.doi.org/10.3389/fmed.2022.870637 Text en Copyright © 2022 Zheng, Yao, Zhou, Xu and Huang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Zheng, Wen-He
Yao, Yan
Zhou, Hua
Xu, Yuan
Huang, Hui-Bin
Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis
title Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis
title_full Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis
title_fullStr Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis
title_full_unstemmed Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis
title_short Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis
title_sort hyperphosphatemia and outcomes in critically ill patients: a systematic review and meta-analysis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9156794/
https://www.ncbi.nlm.nih.gov/pubmed/35665344
http://dx.doi.org/10.3389/fmed.2022.870637
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