Early Hypophosphatemia as a Prognostic Marker in Acute Pancreatitis

Objectives Acute pancreatitis (AP) is a complex disease representing a significant portion of gastrointestinal-related hospitalizations in the U.S. Understanding risk factors of AP might provide attractive therapeutic targets. We evaluated hypophosphatemia a prognostic marker in AP. Methods We performed a retrospective review of electronic health records of patients with AP from 01/ 01/2012–12/31/2021 at Cedars-Sinai Medical Center with serum phosphate measured within 48 hours of admission. Multivariable logistic regression modeling was used to evaluate associations with ICU admission and AP severity. Multivariable log-linear modeling was employed to examine associations with length of stay (LOS). Results Of 1526 patients admitted for AP, 33% (499) had a serum phosphate level measured within 48 hours. Patients with hypophosphatemia were more likely to have ICU admission (adjusted odds ratio (AOR) = 4.57; 95% confidence interval (CI): 2.75–7.62; P < 0.001), have a longer hospital stay (log-LOS = 0.34; SE; 0.09; 95% CI: 0.17–0.52; P < 0.001), and have moderate or severe AP (AOR = 1.80; 95% CI: 1.16–2.80; P < 0.001) compared with those without hypophosphatemia. Conclusion Serum phosphate is infrequently measured in patients with AP and shows promise as an early prognostic marker for outcomes of AP.