Relationship between hypophosphatemia and long-term prognosis of patients in neurological intensive rehabilitation unit during hospitalization
10.3969/j.issn.1008-9691.2024.02.011
- VernacularTitle:神经重症康复患者住院期间低磷血症与长期预后的关系
- Author:
Yanyan YIN
1
;
Aixian LIU
Author Information
1. 首都医科大学附属北京康复医院神经康复中心,北京 100144
- Keywords:
Neurological intensive rehabilitation unit;
Hypophosphatemia;
Poor prognosis
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(2):184-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between minimum blood phosphorus and the long-term prognosis of patients in the neurological intensive rehabilitation unit.Methods The clinical data of patients in the neurological intensive rehabilitation ward of Beijing Rehabilitation Hospital Affiliated to Capital Medical University from December 2020 to June 2022 were analyzed.The data included gender,age,primary diagnosis,Glasgow coma scale(GCS),biochemical phosphorus ion levels(at admission,lowest,highest),white blood cell count(WBC),neutrophil/lymphocyte count ratio(NLR),C-reactive protein(CRP),and procalcitonin(PCT),length of stay in intensive care unit(ICU),total length of stay,6-month and 1-year location,and 6-month and 1-year case mortality.Patients were divided into hypophosphatemia group(serum phosphorus<0.80 mmol/L)and non-hypophosphatemia group(serum phosphorus≥0.80 mmol/L)according to the minimum blood phosphorus during hospitalization,the differences of the above indexes in different blood phosphorus level groups were compared.Multivariate Logistic regression analysis was used to evaluate the relationship between univariate variables and 6-month and 1-year prognosis.The receiver operator characteristic curve(ROC curve)was obtained,area under the curve(AUC)and its 95%confidence interval(95%CI)were calculated to evaluate the value of blood phosphorus level in predicting prognosis of patients in neurological intensive rehabilitation ward in 6 months and 1 year.Results A total of 276 patients were included,including 168 patients in the hypophosphatemia group and 108 patients in the non-hypophosphatemia group.Patients in the hypophosphatemia group had higher PCT and CRP[PCT(μg/L):0.08(0.04,0.16)vs.0.05(0.03,0.14),CRP(mg/L):12.05(3.00,27.63)vs.5.35(1.53,18.88),both P<0.05],lower prealbumin[g/L:0.19(0.14,0.22)vs.0.21(0.17,0.26),P<0.01],longer length of stay in ICU and total length of stay[length of stay in ICU(days):36.0(25.0,78.8)vs.28.0(21.3,46.8),total length of stay(days):116.5(60.0,180.0)vs.78.0(40.2,129.0),both P<0.01],higher 6-month and 1-year mortality[6-month mortality:13.10%(22/168)vs.3.70%(4/108),1-year mortality:26.19%(44/168)vs.11.11%(12/108),both P<0.05]than those in the non-hypophosphatemia group.At 6-month and 1-year follow-up,there was statistical significance between the two groups in different living places(P<0.05).Logistic regression analysis showed that the lowest blood phosphorus level was an independent risk factor for the prognosis of patients in neurological intensive rehabilitation ward[6-month:odds ratio(OR)and 95%CI were 0.160(0.032-0.798),P=0.024;1-year:OR and 95%CI were 0.286(0.091-0.895),P=0.032,respectively].ROC curve analysis showed that the minimum blood phosphorus level had a certain value in predicting the prognosis of patients with severe neurological rehabilitation(6-month:AUC=0.66,95%CI was 0.58-0.75;1-year:AUC=0.62,95%CI was 0.54-0.70,both P<0.01).Conclusions Patients with hypophosphatemia had a longer length of stay in ICU,total length of stay,and higher mortality at 6-month and 1-year compared to those in the non-hypophosphatemia group.The lowest blood phosphorus during hospitalization can predict prognosis at both 6-month and 1-year marks.
