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{
    "pk": 17500,
    "title": "Association of Early Serum Phosphate Levels  and Mortality in Patients with Sepsis",
    "subtitle": null,
    "abstract": "Background: Metabolic derangements in sepsis influence phosphate levels, which may predict mortality outcomes. We investigated the association between initial phosphate levels and 28-day mortality in patients with sepsis.\nMethods: We conducted a retrospective analysis of patients with sepsis. Initial (first 24 hours) phosphate levels were divided into phosphate quartile groups for comparisons. We used repeated-measures mixed-models to assess differences in 28-day mortality across the phosphate groups, adjusting for other predictors identified by the Least Absolute Shrinkage and Selection Operator variable selection technique.\nResults: A total of 1,855 patients were included with 13% overall 28-day mortality (n=237). The highest phosphate quartile (>4.0 milligrams per deciliter [mg/dL]) had a higher mortality rate (28%) than the three lower quartiles (P<0.001). After adjustment (age, organ failure, vasopressor administration, liver disease), the highest initial phosphate was associated with increased odds of 28-day mortality. Patients in the highest phosphate quartile had 2.4 times higher odds of death than the lowest (≤2.6 mg/dL) quartile (P<0.01), 2.6 times higher than the second (2.6-3.2 mg/dL) quartile (P<0.01), and 2.0 times higher than the third (3.2-4.0 mg/dL) quartile (P=0.04).\nConclusion: Septic patients with the highest phosphate levels had increased odds of mortality. Hyperphosphatemia may be an early indicator of disease severity and risk of adverse outcomes from sepsis.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Sepsis, Phosphate levels, mortality"
        }
    ],
    "section": "Endemic Infections",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2fm5842h",
    "frozenauthors": [
        {
            "first_name": "Lauren",
            "middle_name": "Page",
            "last_name": "Black",
            "name_suffix": "",
            "institution": "University of Florida College of Medicine – Jacksonville",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Mohseni",
            "name_suffix": "",
            "institution": "Mayo Clinic, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Ehsan",
            "middle_name": "",
            "last_name": "Shirazi",
            "name_suffix": "",
            "institution": "Mayo Clinic, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Kasondra",
            "middle_name": "",
            "last_name": "Hartman",
            "name_suffix": "",
            "institution": "University of Florida College of Medicine - Jacksonville, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Carmen",
            "middle_name": "",
            "last_name": "Smotherman",
            "name_suffix": "",
            "institution": "University of Florida Health Jacksonville, Center for Data Solutions, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Charlotte",
            "middle_name": "",
            "last_name": "Hopson",
            "name_suffix": "",
            "institution": "University of Florida College of Medicine - Jacksonville, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Elizabeth",
            "middle_name": "",
            "last_name": "DeVos",
            "name_suffix": "",
            "institution": "University of Florida College of Medicine - Jacksonville, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Rosemarie",
            "middle_name": "",
            "last_name": "Fernandez",
            "name_suffix": "",
            "institution": "University of Florida College of Medicine, Department of Emergency Medicine, Gainesville, Florida",
            "department": "None"
        },
        {
            "first_name": "Johnathan",
            "middle_name": "",
            "last_name": "Sheele",
            "name_suffix": "",
            "institution": "Mayo Clinic, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        },
        {
            "first_name": "Faheem",
            "middle_name": "",
            "last_name": "Guirgis",
            "name_suffix": "",
            "institution": "University of Florida College of Medicine - Jacksonville, Department of Emergency Medicine, Jacksonville, Florida",
            "department": "None"
        }
    ],
    "date_submitted": "2022-10-13T21:25:05+02:00",
    "date_accepted": "2022-10-13T21:25:05+02:00",
    "date_published": "2023-04-28T21:27:26+02:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17500/galley/8920/download/"
        }
    ]
}