Hypophosphatemia Is More Common and Is Prognostic of Poorer Outcomes in Severe Alcoholic Pancreatitis. Issue 10 (November 2021)

• Record Type: Journal Article
• Authors: Wagner, Jason; Hernandez-Blanco, Yllen; Yu, Abraham; Garcia-Rodriguez, Victor; Mohajir, Wasay; Goodman, Colin; Farooq, Ahmad
• Is Part Of: Pancreas. Volume 50:Issue 10(2021)
• Page Start: 1440
• Page End: 1444
• Publication Date: 2021-11
• Subjects: alcoholic pancreatitis -- hypophosphatemia -- pancreatitis -- severity of illness -- AAP - alcohol-induced acute pancreatitis -- AKI - acute kidney injury -- AP - acute pancreatitis -- ATP - adenosine triphosphate -- AUC - area under the curve -- BISAP - Bedside Index for Severity in Acute Pancreatitis -- BISA-Phos_admission - BISAP score calculated with admission phosphate criterion added -- BISA-Phos_minimum - BISAP score calculated with minimum phosphate criterion added -- BMI - body mass index -- BUN - blood urea nitrogen -- CKD - chronic kidney disease -- CT - computed tomography -- EMR - electronic medical record system -- ICU - intensive care unit -- LOS - length of stay -- MRI - magnetic resonance imaging -- ROC-AUC - receiver operator characteristics-area under the curve -- SIRS - systemic inflammatory response syndrome; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001952
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Supplemental digital content is available in the text. Abstract : Objectives: The aim of this study was to determine if hypophosphatemia is more common in patients with severe alcohol-induced acute pancreatitis (AAP). Methods: This is a retrospective, single institution, cohort study that analyzed 147 patients admitted to the hospital for AAP. Multivariate logistic regression was used to determine if hypophosphatemia would be related to clinical outcomes of disease severity. Results: Hypophosphatemia was more common in patients with severe AAP at admission; in addition, all patients with severe AAP (100%) eventually developed hypophosphatemia during admission, relative to those with mild (43%) and moderately severe (54%) AAP. The magnitude of the lowest phosphate measurement obtained during admission was lower in patients with severe AAP (mean, 1.5 mg/dL, standard deviation [SD], 0.5 mg/dL) relative to those with mild (mean, 2.6 mg/dL; SD, 0.9 mg/dL) and moderately severe (mean, 2.3 mg/dL; SD, 0.9 mg/dL) AAP ( P < 0.001). Finally, patients who developed hypophosphatemia during admission were more likely to require intensive care unit admission ( P < 0.001), vasopressors ( P = 0.01), or intubation ( P = 0.003). Conclusions: Hypophosphatemia is more common and of greater magnitude in patients admitted to the hospital with severe AAP. In addition, patients with severe AAP who develop hypophosphatemia during admission are more likely to have poorer clinical outcomes.