Serum inorganic phosphorus levels predict 30-day mortality in patients with community acquired pneumonia.
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.
Department of Internal Medicine H, Rambam Health Care Campus, Haifa, Israel. m_naffaa@rambam.health.gov.il.|B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel. m_naffaa@rambam.health.gov.il.|The Rappoport's Faculty of Medicine, Technion, Haifa, Israel. m_naffaa@rambam.health.gov.il.
Mohammad E
ME
Naffaa
Department of Internal Medicine E, Rambam Health Care Campus, Haifa, Israel. mona_m1987@hotmail.com.
Mona
M
Mustafa
The Rappoport's Faculty of Medicine, Technion, Haifa, Israel. mohje.azzam@hotmail.com.
Mohje
M
Azzam
Department of Internal Medicine H, Rambam Health Care Campus, Haifa, Israel. r_nasser@rambam.health.gov.il.
Roni
R
Nasser
Department of Internal Medicine H, Rambam Health Care Campus, Haifa, Israel. a_nizar@rambam.health.gov.il.
Nizar
N
Andria
Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel. z_azzam@rambam.health.gov.il.|The Rappoport's Faculty of Medicine, Technion, Haifa, Israel. z_azzam@rambam.health.gov.il.
Zaher S
ZS
Azzam
Department of Internal Medicine H, Rambam Health Care Campus, Haifa, Israel. e_braun@rambam.health.gov.il.|The Rappoport's Faculty of Medicine, Technion, Haifa, Israel. e_braun@rambam.health.gov.il.|Department of Internal Medicine H and Infectious Diseases Unit, Rambam Health Care Campus, Haa'leya Hashneyya 8, Haifa, 31096, Israel. e_braun@rambam.health.gov.il.
Eyal
E
Braun
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000097:blood / Q000401:mortality*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010758:Phosphorus / Q000097:blood*; D011014:Pneumonia / Q000097:blood / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
D010758:Phosphorus