Evidence mapPaperPMID 39984839Full record

ArticleBMC infectious diseases2025

Effect of changes trajectory of serum phosphate levels on the 28-day mortality risk in patients with sepsis: a retrospective cohort study from the MIMIC-IV database.

Rui Zhang, Dingxing Zhou

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Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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3 citing papers in PubMed.

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5 · Who and what money

Authors and funding

2 authors.

Rui ZhangDepartment of Emergency, Wuxi No.2 Chinese Medicine Hospital, No. 390 Xincheng Road, Binhu District, Wuxi, 214121, Jiangsu, P.R. China.
Dingxing ZhouDepartment of Emergency, Wuxi No.2 Chinese Medicine Hospital, No. 390 Xincheng Road, Binhu District, Wuxi, 214121, Jiangsu, P.R. China. dingxingzcm@outlook.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSerum phosphate levels have been reported to be linked to the prognosis in critically ill patients. The purpose of this study was to analyze the impact of the trajectory of changes in serum phosphate levels on the short-term mortality risk in patients with sepsis.

methodsThis retrospective cohort study used data on patients with sepsis from the 2008-2019 Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Serum phosphate level trajectories were constructed using a latent growth mixture modeling (LGMM) based on four measurements of serum phosphate at six-hour intervals within 24 h of admission to the intensive care unit (ICU). The relationship between serum phosphate levels at ICU admission and serum phosphate level trajectories and the risk of 28-day mortality in patients with sepsis was analyzed using Cox regression models, and hazard ratio (HR) and 95% confidence interval (CI) were calculated.

resultsOf these 1,703 patients with sepsis included, 566 (33.24%) died within 28 days. The median serum phosphate levels of the patients were 4.10 (3.00, 5.50) mg/dL. Four serum phosphate level trajectories were classified: normal-level-steady trend (trajectory 1), high-level-steady trend (trajectory 2), high-level-decreasing trend (trajectory 3), and high-level-increasing trend (trajectory 4). High serum phosphate levels at admission were associated with a higher risk of 28-day mortality (HR = 1.05, 95%CI: 1.01-1.09) in patients with sepsis. For trajectories, trajectory 2 (HR = 1.27, 95%CI: 1.05-1.54) related to an increased risk of 28-day mortality compared with trajectory 1, whereas trajectory 4 (HR = 1.69, 95%CI: 0.99-2.91, P = 0.056) may be related. There was no significant difference in 28-day mortality between patients on trajectory 3 and trajectory 1 (P = 0.280). Subgroup analyses demonstrated that patients with trajectory 2 were linked to a higher risk of 28-day mortality in different population subgroups (P < 0.05).

conclusionStable trajectories of high serum phosphate levels are an important risk factor for short-term mortality in patients with sepsis.

Indexed as

PhosphatesSepsisAgedAged, 80 and overCritical IllnessDatabases, FactualFemaleHumansIntensive Care UnitsMaleMiddle AgedPrognosisProportional Hazards ModelsRetrospective StudiesRisk FactorsPhosphates28-day mortalityMIMIC-IVSepsisSerum phosphateTrajectory

Identifiers

PMID39984839
PMCPMC11844063

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.