Associations of serum phosphate levels and intravenous phosphate exposure with mortality in patients with sepsis: a multi-database retrospective study - Nature
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AbstractAbnormal phosphate concentrations are common in sepsis, but the prognostic relevance of serum phosphate and the association between recorded intravenous phosphate exposure and mortality remain uncertain. This retrospective cohort study used MIMIC-III, MIMIC-IV, and a single-center database from the First Affiliated Hospital of Chongqing Medical University. Adults with ICD-coded sepsis, a first ICU admission, and an ICU stay longer than 24 h were included. Admission phosphate was evaluated with restricted cubic spline regression for 28- and 90-day mortality. Recorded intravenous phosphate exposure was assessed using multivariable logistic regression in the 48- and 72-h landmark populations. Propensity-score matching and inverse-probability-of-treatment weighting were performed at both landmarks. A target-trial emulation was also performed. Cohorts 1 and 2 included 15,426 and 967 patients, respectively.
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