title: Change of serum phosphate level and clinical outcome of hypophosphatemia in massive burn patient.
abstract: BACKGROUND
  Hypophosphatemia is relatively common phenomenon in patients with massive burn injury. Therefore, we check serum phosphate level routinely and try to supply phosphate in a timely manner. The purpose of this study was to investigate the change of the serum phosphate level of early postburn period and the impact of hypophosphatemia on the prognosis of patients.
  
  
  METHODS
  A total of 227 patients with burn injury were reviewed retrospectively. We performed analysis of serum phosphate level within 20 days from burn injury.
  
  
  RESULTS
  Patients' mean (SD) age was 47.0 (14.1) years, and mean (SD) percentage of total body surface area burned were 47.7 (21.9). Severe hypophosphatemia (phosphate < 1.0 mg/dL) was observed in 35 patients (15.8%), and moderate hypophosphatemia (1.0 ≤ phosphate < 2.0 mg/dL) was found in 115 patients (50.6%). Therefore, overall incidence of hypophosphatemia was 66.4%. There was no significant difference in serum phosphate level with survival, total body surface area burned, and mechanical ventilation. Age (odds ratio [OR], 3.180; 95% confidence interval [CI], 1.025-9.871; p = 0.045), total body surface area burned (OR, 20.934; 95% CI, 6.845-64.024; p = 0.000), and mechanical ventilation (OR, 5.581; 95% CI, 2.380-13.085; p = 0.002) were independently associated with mortality. However, serum phosphate level (OR, 0.828; 95% CI, 0.275-2.495; p = 0.737) does not have a statistical significance.
  
  
  CONCLUSIONS
  Although multiple studies have evaluated the efficacy and safety of phosphate repletion regimens, the effect on mortality and morbidity is not well reported. However, our results show that patients with massive burn injury have high incidence of hypophosphatemia, and hypophosphatemia can result in many complications. Therefore, routine check and supply of phosphate can be suggested in patients with massive burn injury.
  
  
  METHODS
  Prognostic study, level II.
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors.forename: Hyeong Tae
authors.initials: HT
authors.lastname: Yang
authors.forename: Haejun
authors.initials: H
authors.lastname: Yim
authors.forename: Yong Suk
authors.initials: YS
authors.lastname: Cho
authors.forename: Dohern
authors.initials: D
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Hur
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Boung Chul
authors.initials: BC
authors.lastname: Lee
authors.forename: Cheong Hoon
authors.initials: CH
authors.lastname: Seo
authors.forename: Wook
authors.initials: W
authors.lastname: Chun
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000097:blood* / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D010710:Phosphates