Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis
Background There remain controversies over the conclusion of different serum phosphate levels as prognostic predictors of sepsis patients. As such, this study investigated the association between different serum phosphate and the prognosis of sepsis. Methods Data from PubMed, Embase, Cochrane Librar...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PeerJ Inc.
2023-10-01
|
| Series: | PeerJ |
| Subjects: | |
| Online Access: | https://peerj.com/articles/16241.pdf |
| _version_ | 1827608117441986560 |
|---|---|
| author | Shengfeng Wei Yunhan Li Chunhua Zhang Xiangjian Guo Xinmeng Liang Yanmei Huang Fan Zhang Jihong Li Qiangqiang Liu |
| author_facet | Shengfeng Wei Yunhan Li Chunhua Zhang Xiangjian Guo Xinmeng Liang Yanmei Huang Fan Zhang Jihong Li Qiangqiang Liu |
| author_sort | Shengfeng Wei |
| collection | DOAJ |
| description | Background There remain controversies over the conclusion of different serum phosphate levels as prognostic predictors of sepsis patients. As such, this study investigated the association between different serum phosphate and the prognosis of sepsis. Methods Data from PubMed, Embase, Cochrane Library, and Web of Science were systematically retrieved from the inception of databases to June 1, 2023 and independently screened and extracted by two authors. Binary variables in the study were estimated as relative risk ratio (RR) and 95% confidence interval (CI), and continuous variables were estimated as mean and standard deviation. The Newcastle-Ottawa Scale (NOS) was employed to evaluate the quality of the included studies, and subgroup analysis and sensitivity analysis were performed for all outcomes to explore the sources of heterogeneity. Results Ten studies were included in this study including 38,320 patients with sepsis or septic shock. Against normal serum phosphate levels, a high serum phosphate level was associated with an elevated all-cause mortality risk (RR = 1.46; 95% CI [1.22–1.74]; P = 0.000) and prolonged Intensive Care Unit (ICU) length of stay (LOS) (WMD = 0.63; 95% CI [0.27–0.98]; P = 0.001). However, there was no significant difference in the in-hospital LOS (WMD = 0.22; 95% CI [−0.61–1.05]; P = 0.609). A low serum phosphate level was not significantly associated with the all-cause mortality risk (RR = 0.97; 95% CI [0.86–1.09]; P = 0.588), ICU LOS (WMD = −0.23; 95% CI [−0.75–0.29]; P = 0.394) and in-hospital LOS (WMD = −0.62; 95% CI [−1.72–0.49]; P = 0.274). Conclusion Sepsis patients with high serum phosphate levels before therapeutic interventions were associated with a significant increase in the all-cause mortality risk, prolonged ICU LOS, and no significant difference in in-hospital LOS. Sepsis patients with low serum phosphate levels before interventions may have a reduced risk of all-cause mortality, shorter ICU LOS, and in-hospital LOS, but the results were not statistically significant. |
| first_indexed | 2024-03-09T07:05:15Z |
| format | Article |
| id | doaj.art-8c778a40d12145508570033c6a229c4a |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T07:05:15Z |
| publishDate | 2023-10-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-8c778a40d12145508570033c6a229c4a2023-12-03T09:36:29ZengPeerJ Inc.PeerJ2167-83592023-10-0111e1624110.7717/peerj.16241Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysisShengfeng WeiYunhan LiChunhua ZhangXiangjian GuoXinmeng LiangYanmei HuangFan ZhangJihong LiQiangqiang LiuBackground There remain controversies over the conclusion of different serum phosphate levels as prognostic predictors of sepsis patients. As such, this study investigated the association between different serum phosphate and the prognosis of sepsis. Methods Data from PubMed, Embase, Cochrane Library, and Web of Science were systematically retrieved from the inception of databases to June 1, 2023 and independently screened and extracted by two authors. Binary variables in the study were estimated as relative risk ratio (RR) and 95% confidence interval (CI), and continuous variables were estimated as mean and standard deviation. The Newcastle-Ottawa Scale (NOS) was employed to evaluate the quality of the included studies, and subgroup analysis and sensitivity analysis were performed for all outcomes to explore the sources of heterogeneity. Results Ten studies were included in this study including 38,320 patients with sepsis or septic shock. Against normal serum phosphate levels, a high serum phosphate level was associated with an elevated all-cause mortality risk (RR = 1.46; 95% CI [1.22–1.74]; P = 0.000) and prolonged Intensive Care Unit (ICU) length of stay (LOS) (WMD = 0.63; 95% CI [0.27–0.98]; P = 0.001). However, there was no significant difference in the in-hospital LOS (WMD = 0.22; 95% CI [−0.61–1.05]; P = 0.609). A low serum phosphate level was not significantly associated with the all-cause mortality risk (RR = 0.97; 95% CI [0.86–1.09]; P = 0.588), ICU LOS (WMD = −0.23; 95% CI [−0.75–0.29]; P = 0.394) and in-hospital LOS (WMD = −0.62; 95% CI [−1.72–0.49]; P = 0.274). Conclusion Sepsis patients with high serum phosphate levels before therapeutic interventions were associated with a significant increase in the all-cause mortality risk, prolonged ICU LOS, and no significant difference in in-hospital LOS. Sepsis patients with low serum phosphate levels before interventions may have a reduced risk of all-cause mortality, shorter ICU LOS, and in-hospital LOS, but the results were not statistically significant.https://peerj.com/articles/16241.pdfSepsisPhosphateHyperphosphatemiaHypophosphatemiaMeta-analysisReview |
| spellingShingle | Shengfeng Wei Yunhan Li Chunhua Zhang Xiangjian Guo Xinmeng Liang Yanmei Huang Fan Zhang Jihong Li Qiangqiang Liu Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis PeerJ Sepsis Phosphate Hyperphosphatemia Hypophosphatemia Meta-analysis Review |
| title | Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis |
| title_full | Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis |
| title_fullStr | Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis |
| title_full_unstemmed | Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis |
| title_short | Prognostic value of serum phosphate levels in sepsis: a systematic review and meta-analysis |
| title_sort | prognostic value of serum phosphate levels in sepsis a systematic review and meta analysis |
| topic | Sepsis Phosphate Hyperphosphatemia Hypophosphatemia Meta-analysis Review |
| url | https://peerj.com/articles/16241.pdf |
| work_keys_str_mv | AT shengfengwei prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT yunhanli prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT chunhuazhang prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT xiangjianguo prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT xinmengliang prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT yanmeihuang prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT fanzhang prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT jihongli prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis AT qiangqiangliu prognosticvalueofserumphosphatelevelsinsepsisasystematicreviewandmetaanalysis |