Hyperphosphatemia is associated with high mortality in severe burns

George Kuo, Cheng Chia Lee, Shih Yi Yang, Yen Chang Hsiao, Shiow Shuh Chuang, Su Wei Chang, Kun Hua Tu, Pei Chun Fan, Ya Chung Tian, Yung Chang Chen, Chih Hsiang Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

20 Scopus citations

Abstract

Introduction Phosphate level is often deranged during acute illness, regardless of the presence of kidney injury or not. A few studies described that hypophosphatemia may associated with outcome in patients admitted to the burn unit, but the literatures for hyperphosphatemia is limited. Our study aims to evaluate if hyperphosphatemia, one of the sign of severe tissue damage or kidney injury, will associate with mortality of patients with severe burns. Materials and methods The study was a post hoc analysis of prospectively collected data from patients admitted to the burn unit between September 2006 and December 2011. Patients were stratified into normophosphatemic or hyperphosphatemic group by baseline plasma phosphate level. The primary endpoint is 90-day mortality. Results Total 301 patients were included (hyperphosphatemia: n = 52; normophosphatemia: n = 249). The hyperphosphatemic group had lower Glasgow Coma Scale, mean arterial blood pressure, hemoglobin level, albumin, and higher TBSA of burns, APACHE II score, ABSI score, Acute kidney injury (AKI), and creatinine. The 90-day mortality was higher in the hyperphosphatemic group than in the normal group (53.8% vs 18.1%, P < .001) and this difference was still significant when adjusting for several confounding factors (hazard ratio, 2.05; 95% CI, 1.17–3.59). Multivariable Cox analysis showed risk factors of mortality included TBSA of burns, hyperphosphatemia, reduced urine output, and APACHE II score. Conclusions Our study found in addition to TBSA of burns and inhalation injury, baseline hyperphosphatemia in patients with severe burns is also associated with higher mortality.

Original languageEnglish
Article numbere0190978
JournalPLoS ONE
Volume13
Issue number1
DOIs
StatePublished - 01 2018

Bibliographical note

Publisher Copyright:
© 2018 Kuo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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