A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU

Objectives: Hypophosphatemia is frequently encountered in the ICU and is associated with mortality rates up to 30%. Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU pa...

Full description

Bibliographic Details
Main Authors:	Mat Nor, Mohd. Basri, Md Ralib, Azrina, Mohamed, Rozilah @ Abdul Hadi
Format:	Conference or Workshop Item
Language:	English
Published:	2011
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/16254/ http://irep.iium.edu.my/16254/1/asmic_2011_ph.pdf

id	iium-16254
recordtype	eprints
spelling	iium-162542012-02-23T04:48:26Z http://irep.iium.edu.my/16254/ A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU Mat Nor, Mohd. Basri Md Ralib, Azrina Mohamed, Rozilah @ Abdul Hadi R Medicine (General) Objectives: Hypophosphatemia is frequently encountered in the ICU and is associated with mortality rates up to 30%. Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective non-interventional study assessing adults admitted to ICU in between March and May 2009. Patients aged >18 years old were included; patients without baseline phosphate level and renal failure (±dialysis) were excluded. All patients were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Statistically significant when p value <0.05. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41).Gender and creatinine clearance was found to be significantly different between normophosphatemia and hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate levels, creatinine clearance and pH were significant predictors to the serum phosphate. A significant difference of mean serum phosphate levels were seen after repletion with IV phosphate by total dose of 10, 20 and 40 mmols in the treatment subgroups (mild, moderate and severe). Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum level in hypophosphatemia patients. 2011-07 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/16254/1/asmic_2011_ph.pdf Mat Nor, Mohd. Basri and Md Ralib, Azrina and Mohamed, Rozilah @ Abdul Hadi (2011) A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU. In: Annual Scientific Meeting on Intensive Care, 15th to 17th July 2011, Shangri-La Hotel, Kuala Lumpur, Malaysia.
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Mat Nor, Mohd. Basri Md Ralib, Azrina Mohamed, Rozilah @ Abdul Hadi A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU
description	Objectives: Hypophosphatemia is frequently encountered in the ICU and is associated with mortality rates up to 30%. Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective non-interventional study assessing adults admitted to ICU in between March and May 2009. Patients aged >18 years old were included; patients without baseline phosphate level and renal failure (±dialysis) were excluded. All patients were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Statistically significant when p value <0.05. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41).Gender and creatinine clearance was found to be significantly different between normophosphatemia and hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate levels, creatinine clearance and pH were significant predictors to the serum phosphate. A significant difference of mean serum phosphate levels were seen after repletion with IV phosphate by total dose of 10, 20 and 40 mmols in the treatment subgroups (mild, moderate and severe). Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum level in hypophosphatemia patients.
format	Conference or Workshop Item
author	Mat Nor, Mohd. Basri Md Ralib, Azrina Mohamed, Rozilah @ Abdul Hadi
author_facet	Mat Nor, Mohd. Basri Md Ralib, Azrina Mohamed, Rozilah @ Abdul Hadi
author_sort	Mat Nor, Mohd. Basri
title	A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU
title_short	A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU
title_full	A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU
title_fullStr	A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU
title_full_unstemmed	A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU
title_sort	study on incidence, predictors and management of hypophosphaemia in a malaysian icu
publishDate	2011
url	http://irep.iium.edu.my/16254/ http://irep.iium.edu.my/16254/1/asmic_2011_ph.pdf
first_indexed	2023-09-18T20:25:08Z
last_indexed	2023-09-18T20:25:08Z
_version_	1777408365874380800

A study on incidence, predictors and management of hypophosphaemia in a Malaysian ICU

Similar Items