外周血磷酸盐水平与老年急性感染患者不良预后风险的相关性

doi:10.3969/j.issn.1003-9198.2026.03.011

摘要/Abstract

摘要： 目的探讨外周血磷酸盐水平与老年急性感染患者不良预后风险的相关性。方法回顾性选取廊坊市人民医院2019年1月至2023年12月入住ICU且住院时间超过72 h的246例老年急性感染患者作为研究对象,根据其住院期间的死亡情况分为存活组和死亡组,收集患者入院24 h内的外周血磷酸盐水平以及临床资料,采用多因素logistic回归分析老年急性感染患者不良预后风险的影响因素,同时根据入院24 h内的外周血磷酸盐水平将患者分为低水平组、正常水平组以及高水平组,采用Kapian-Meier生存曲线分析外周血磷酸盐水平与住院死亡率的关系,采用多因素Cox回归模型评估外周血磷酸盐水平的预后价值。结果多因素logistic回归分析显示,序贯器官衰竭(SOFA)评分(OR=2.343)、ALT(OR=1.079)、降钙素原(OR=8.668)、ICU入住时间(OR=5.390)、抗生素种类(OR=6.131)以及外周血磷酸盐水平(OR=12.314)是老年急性感染患者不良预后的独立影响因素(均P<0.05)。低水平组(n=41)、正常水平组(n=77)以及高水平组(n=128)患者的住院死亡率比较,差异具有统计学意义(P<0.01),其中高水平组患者(49例,38.28%)的住院死亡率显著高于正常水平组(12例,15.58%)(P<0.01),但与低水平组(11例,26.83%)差异无统计学意义(P>0.05)。Cox回归分析显示,在调整混杂因素后,高外周血磷酸盐水平与住院死亡率的增加独立相关(P<0.05)。结论入院24 h内外周血磷酸盐水平对于评估老年急性感染患者的不良预后风险具有重要意义。

关键词: 急性感染, 老年人, 外周血磷酸盐水平, 不良预后风险, 住院死亡

Abstract: Objective To explore the correlation between peripheral blood phosphate level and poor prognosis risk in the elderly patients with acute infections. Methods A retrospective study was conducted on 246 elderly patients with acute infections admitted to ICU of Langfang People’s Hospital from January 2019 to December 2023, with a hospitalization duration exceeding 72 hours. Based on mortality outcomes during hospitalization, the patients were divided into a survival group and a mortality group. Peripheral blood phosphate level and clinical data were collected within 24 hours of admission. Multivariate logistic regression analysis was performed to identify risk factors for poor prognosis in elderly patients with acute infections. Patients were further stratified into low-, normal-, and high-level peripheral blood phosphate groups based on admission 24-hour phosphate level. Kaplan-Meier survival curve analysis was used to evaluate the relationship between peripheral blood phosphate level and in-hospital mortality, while a multivariate Cox regression model was employed to assess the prognostic value of peripheral blood phosphate level. Results Multivariate logistic regression analysis showed that Sequential Organ Failure Assessment (SOFA) score (OR=2.343), alanine aminotransferase (OR=1.079), procalcitonin (OR=8.668), ICU stay (OR=5.390), number of antibiotics types (OR=6.131) and peripheral blood phosphate level (OR=12.314) were risk factors for poor prognosis in elderly patients with acute infections. There was a statistically significant difference in the in-hospital mortality rate among the low-level group (n=41), normal-level group (n=77) and high-level group (n=128) (P<0.01). The in-hospital mortality rate was significantly higher in the high-level group (49 cases, 38.28%) compared to the normal-level group (12 cases, 15.58%) (P<0.01), but no statistically significant difference was observed when compared with the low-level group (11 cases, 26.83%) (P>0.05). Cox regression analysis revealed that elevated peripheral blood phosphate level was independently associated with increased in-hospital mortality after adjustment for confounding factors (P<0.05). Conclusions Peripheral blood phosphate level within 24 hours after admission shows great significance for evaluation of poor prognosis risk in the elderly patients with acute infections.

Key words: acute infections, aged, peripheral blood phosphate level, risk of adverse prognosis, death in hospital

中图分类号:

R 446.11

张立彦, 冯雪菲, 陈琳, 赵永华. 外周血磷酸盐水平与老年急性感染患者不良预后风险的相关性[J]. 实用老年医学, 2026, 40(3): 278-282.

ZHANG Liyan, FENG Xuefei, CHEN Lin, ZHAO Yonghua. Correlation between peripheral blood phosphate level and poor prognosis risk in elderly patients with acute infections[J]. Practical Geriatrics, 2026, 40(3): 278-282.

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