Admission hyperphosphatemia as a predictor of severity and mortality in acute pancreatitis: A 1000-patient cohort study

Table 1 Baseline demographic and etiological characteristics of patients with acute pancreatitis stratified by admission serum phosphate levels

Characteristic	Entire cohort (n = 1000)	Hypophosphatemia (< 2.5 mg/dL, n = 150)	Normophosphatemia (2.5-4.5 mg/dL, n = 750)	Hyperphosphatemia (> 4.5 mg/dL, n = 100)	P value
Age, median (IQR), years	55 (45-64)	54 (43–63)	53 (44–62)	60 (50–68)	0.02
Male sex	550 (55.0)	80 (53.3)	400 (53.3)	65 (65.0)	0.03
Gallstone-related AP	600 (60.0)	90 (60.0)	480 (64.0)	40 (40.0)	< 0.001

Values are presented as n (%) unless otherwise indicated. Continuous variables are shown as median (interquartile range). AP: Acute pancreatitis.

Table 2 Clinical outcomes according to admission serum phosphate levels

Clinical outcome	Hypophosphatemia (< 2.5 mg/dL, n = 150)	Normophosphatemia (2.5-4.5 mg/dL, n = 750)	Hyperphosphatemia (> 4.5 mg/dL, n = 100)	P value
Severe acute pancreatitis	60 (40)	150 (20)	60 (60)	< 0.001
Pancreatic necrosis	30 (20)	75 (10)	50 (50)	< 0.001
ICU requirement	45 (30)	113 (15)	70 (70)	< 0.001
Length of hospital stay, median (days)	10	7	14	< 0.001
30-day mortality	8 (5)	23 (3)	25 (25)	< 0.001

Outcomes are presented as n (%), except for length of stay, which is shown as median days. ICU: Intensive care unit.

Table 3 Severity classification of acute pancreatitis according to the revised Atlanta criteria

Severity category (revised Atlanta Classification)	n (%)
Mild/moderately severe AP	750 (75)
SAP	250 (25)

SAP: Severe acute pancreatitis; AP: Acute pancreatitis.

Table 4 Multivariable-adjusted outcomes according to admission phosphate levels

Outcome	Crude (hyper vs normo) (%)	Adjusted OR (95%CI)	P value
Severe AP	60 vs 20	4.2 (2.3-7.8)	< 0.001
Pancreatic necrosis	50 vs 10	5.9 (3.1-11.2)	< 0.001
ICU requirement	70 vs 15	6.5 (3.8-12.0)	< 0.001
30-day mortality	25 vs 3	5.8 (2.9-11.5)	< 0.001

Adjusted ORs were derived from multivariable logistic regression models adjusted for age, sex, etiology, and comorbidities. Hyperphosphatemia was compared to normophosphatemia as the reference group. ICU: Intensive care unit; AP: Acute pancreatitis.