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. 2015 Aug 13:15:332.
doi: 10.1186/s12879-015-1094-6.

Serum inorganic phosphorus levels predict 30-day mortality in patients with community acquired pneumonia

Mohammad E Naffaa  1   2   3 , Mona Mustafa  4 , Mohje Azzam  5 , Roni Nasser  6 , Nizar Andria  7 , Zaher S Azzam  8   9 , Eyal Braun  10   11   12
Affiliations

Serum inorganic phosphorus levels predict 30-day mortality in patients with community acquired pneumonia

Mohammad E Naffaa et al. BMC Infect Dis. .

Abstract

Background: Community acquired pneumonia is a major cause of morbidity and mortality. The association between serum phosphorus levels on admission and the outcome of patients with community acquired pneumonia has not been widely examined. We aimed to investigate the prognostic value of serum phosphorus levels on admission on the 30- day mortality.

Methods: The cohort included patients of 18 years old or older who were diagnosed with community acquired pneumonia between 2006 and 2012. Patients were retrospectively analyzed to identify risk factors for a primary endpoint of 30-day mortality. Binary logistic regression analysis was used for the calculation of the odds ratios (OR) and p values in bivariate and multivariate analysis to identify association between patients' characteristic and 30-day mortality.

Results: The cohort included 3894 patients. In multivariate regression analysis, variables associated with increased risk of 30-day mortality included: age >80 years, increased CURB-65 score, RDW >15, hypernatremia >150 mmol/l, hypoalbuminemia <2 gr/dl and abnormal levels of phosphorus. Levels of <1.5 mg/dl and >4.5 mg/dl were significantly associated with excess 30-day mortality, 38 % (OR 2.9, CI 1.8-4.9, P = 0.001) and 39 % (OR 3.4, CI 2.7-4.2, P = 0.001), respectively. Phosphorus levels within the upper normal limits (4-4.5 mg/dl) were associated with higher mortality rates compared to levels between 1.5-3.5 mg/dl, the reference group, 24 % (OR 1.9, CI 1.5-2.4, P = 0.001).

Conclusions: Abnormal phosphorus levels on admission are associated with increased mortality rates among patients hospitalized with Community acquired pneumonia.

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Figures

Fig. 1
Fig. 1
Serum Phosphrus ROC Curve
Fig. 2
Fig. 2
30-day mortality according to phosphorus levels
Fig. 3
Fig. 3
The relationship between GFR, Phosphorus and Mortality
Fig. 4
Fig. 4
The relationship between CURB-65, Phosphorus and Mortality
Fig. 5
Fig. 5
the relationship between BUN, Phosphorus and Mortality
See this image and copyright information in PMC

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