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Incidence, severity and timing of hypophosphataemia in Glasgow Royal Infirmary ICU

Introduction

Hypophosphataemia is a common treatable problem in ICU, and is indicative of many pathophysiological processes that occur in critical illness. This audit's objective was to quantify the incidence, severity and timing of hypophosphataemia in the ICU. Namely, the incidence of hypophosphataemia on ICU admission and the incidence that develops following admission.

Methods

A retrospective audit of data entered into the computerised medical record database (CareVue) from all admissions between 27 April 2006 and 7 July 2008. The time, date and value of all serum phosphate concentrations were analysed. Abnormal phosphate concentrations were categorised as following: critically low (< 0.3 mmol/l), low (< 0.7 mmol/l), high (>1.5 mmol/l).

Results

A total 689 out of 795 patients admitted during this period had a serum phosphate recorded. Table 1 presents the classification of phosphate concentrations on admission to the ICU and the minimum reached during their ICU admission. The incidence of hypophosphataemia on admission to GRI ICU is 10%, of which <1% is at a critical concentration. The incidence of hypophosphataemia during the whole of the ICU stay rises to 42%. Five per cent of ICU admissions get critical hypophosphataemia at some point during their ICU stay; 69% of these patients have a normal or high phosphate concentration on admission, 19% have a low admission phosphate and 13% are admitted with a critically low phosphate concentration.

Table 1 Phosphate concentrations in ICU admissions (n = 689)

Conclusion

Hypophosphataemia is common in ICU admissions. Most commonly it develops subsequent to admission to the ICU and reaches critical concentrations in 5% of ICU admissions. The timing of this fall in phosphate may indicate specific pathophysiological processes and merits further investigation.

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Gilhooly, C., O'Reilly, D., Mackie, S. et al. Incidence, severity and timing of hypophosphataemia in Glasgow Royal Infirmary ICU. Crit Care 13, P453 (2009). https://doi.org/10.1186/cc7617

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Keywords

  • Critical Illness
  • Phosphate Concentration
  • Critical Concentration
  • Pathophysiological Process
  • Serum Phosphate