TY - JOUR
T1 - Serum phosphate is associated with mortality among patients admitted to ICU for acute pancreatitis
AU - Hedjoudje, Abdellah
AU - Farha, Jad
AU - Cheurfa, Chérifa
AU - Grabar, Sophie
AU - Weiss, Emmanuel
AU - Badurdeen, Dilhana
AU - Kumbhari, Vivek
AU - Prat, Frédéric
AU - Levy, Philippe
AU - Piton, Gaël
N1 - Publisher Copyright:
© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.
PY - 2021/6
Y1 - 2021/6
N2 - Background and Aims: Routine laboratory tests can be useful predictors in the early assessment of the severity and mortality of acute pancreatitis (AP). The aim of this study was to evaluate the accuracy of clinical and laboratory parameters for the prediction of mortality among patients admitted to the intensive care unit (ICU) for AP. Methods: We conducted a retrospective analysis of prospectively collected data from Beth Israel Deaconess Hospital made publicly available to examine the relationship between routine clinical and laboratory parameters with respect to mortality for AP. Cox proportional hazard ratio was used to evaluate the impact of several routine laboratory markers on mortality. Receiver operation characteristic (ROC) curve was performed to determine the accuracy of diagnosis of laboratory tests by using area under curve (AUC) for the respective analysis. Results: In total, 499 patients were admitted to the ICU for AP. Several factors for predicting mortality in AP at admission were identified in the multivariate analysis: alkaline phosphatase hazard ratio (HR) = 1.00 (1.00–1.00, p = 0.024), anion gap HR = 1.09 (1.00–1.20, p = 0.047), bilirubin total HR = 1.11 (1.06–1.17, p < 0.001), calcium total HR = 0.59 (0.42–0.84, p = 0.004), phosphate HR = 1.51 (1.18–1.94, p = 0.001), potassium HR = 1.91 (1.03–3.55, p = 0.041), white blood cells HR = 1.04 (1.00–1.07, p = 0.028). The AUC of serum phosphate level for mortality was 0.7 in the ROC analysis. The optimal cut-off value of serum phosphate level for prediction of mortality was 3.78 mg/dl (sensitivity, 0.58; specificity, 0.78). Conclusion: In this large cohort, we identified baseline serum phosphate as the most valuable single routine laboratory test for predicting mortality in AP. Future prospective studies are required to confirm these results.
AB - Background and Aims: Routine laboratory tests can be useful predictors in the early assessment of the severity and mortality of acute pancreatitis (AP). The aim of this study was to evaluate the accuracy of clinical and laboratory parameters for the prediction of mortality among patients admitted to the intensive care unit (ICU) for AP. Methods: We conducted a retrospective analysis of prospectively collected data from Beth Israel Deaconess Hospital made publicly available to examine the relationship between routine clinical and laboratory parameters with respect to mortality for AP. Cox proportional hazard ratio was used to evaluate the impact of several routine laboratory markers on mortality. Receiver operation characteristic (ROC) curve was performed to determine the accuracy of diagnosis of laboratory tests by using area under curve (AUC) for the respective analysis. Results: In total, 499 patients were admitted to the ICU for AP. Several factors for predicting mortality in AP at admission were identified in the multivariate analysis: alkaline phosphatase hazard ratio (HR) = 1.00 (1.00–1.00, p = 0.024), anion gap HR = 1.09 (1.00–1.20, p = 0.047), bilirubin total HR = 1.11 (1.06–1.17, p < 0.001), calcium total HR = 0.59 (0.42–0.84, p = 0.004), phosphate HR = 1.51 (1.18–1.94, p = 0.001), potassium HR = 1.91 (1.03–3.55, p = 0.041), white blood cells HR = 1.04 (1.00–1.07, p = 0.028). The AUC of serum phosphate level for mortality was 0.7 in the ROC analysis. The optimal cut-off value of serum phosphate level for prediction of mortality was 3.78 mg/dl (sensitivity, 0.58; specificity, 0.78). Conclusion: In this large cohort, we identified baseline serum phosphate as the most valuable single routine laboratory test for predicting mortality in AP. Future prospective studies are required to confirm these results.
KW - mortality
KW - pancreatitis
KW - risk factors
KW - serum phospahte
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U2 - 10.1002/ueg2.12059
DO - 10.1002/ueg2.12059
M3 - Article
C2 - 33951327
AN - SCOPUS:85105098793
SN - 2050-6406
VL - 9
SP - 534
EP - 542
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 5
ER -