Serum phosphorus levels as a predictor and severity marker for mechanical ventilation in adults versus elderly patients – A cross-sectional study

Abstract

Objectives Mechanical ventilation (MV) is a supportive therapy for patients with acute respiratory failure. Studies have shown direct relationship between serum phosphorus on admission and risk of respiratory failure requiring MV. This study aims to determine admission serum phosphorus level’s ability to predict severity in 64 mechanically ventilated patients among two groups: Group A was designated to adults (<60 years of age) and Group B to elderly (60 years or older) admitted to the critical care unit (CCU). Study Design: It is a cross-sectional study. Material and Methods Data were collected from 64 adults admitted to CCU. The Sequential Organ Failure Assessment (SOFA) score and serum Phosphorous level on admission were assessed. Patients with Diabetic Ketoacidosis, Head Trauma, Renal Failure, Hyper or Hypoparathyroidism, Leukaemia, and Lymphoma were excluded. Results The study had 32 subjects in each group. The commonest indication for mechanical ventilation was Poisoning (31.25%) in Group A and Cerebrovascular Accident (34.37%) in Group B. The common complication among the study group was ventilator- associated pneumonia (14.06%). Out of 64 patients requiring mechanical ventilation, nine patients had hypophosphatemia, and eighteen had hyperphosphatemia. In the case of hypophosphatemia, 100% and in hyperphosphatemia, 55.5% mortality was observed. Conclusion Altered serum phosphorus levels on admission can be a potential indicator for requiring MV and mortality. Both hypophosphatemia and hyperphosphatemia are potential risk factors for the development of respiratory failure. Also, age-related variation in phosphorous levels has not shown any association with the outcome.