Kuo et al evaluated patients with severe burns. They identified hyperphosphatemia as an independent risk factor for mortality. The authors are from Chang Gung Memorial Hospital and University in Taiwan.
Patient selection: severe burns
Outcome: 90-day mortality rate
Risk factors for mortality:
(1) hyperphosphatemia (> 4.5 mg/dL) on admission
(2) persistent or progressive hyperphosphatemia (HR 2.1)
(3) high total burn body surface area (HR 1.05 per 10%)
(4) high APACHE II score (HR 1.1 per unit; HR for a score of 8 is 2.1)
(5) low urine output in liters per day (HR 0.78)
The HR for inhalation injury was 0.61 in the multifactorial model (p 0.063), but 50% of patients with hyperphosphatemia showed inhalation injury vs 35% of normophosphatemic patients.
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