Skip to main content
SpringerLink
Log in

Effect of hypophosphatemia on prognosis after spontaneous intracerebral hemorrhage: a retrospective study

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Objective

Hypophosphatemia often occurs after spontaneous intracerebral hemorrhage, but the effect of hypophosphatemia on its prognosis is under debate.

Methods

Clinical data of patients with spontaneous intracerebral hemorrhage admitted to our neurosurgery department from January 2018 to June 2020 were retrospectively analyzed. The patients were divided into the hypophosphatemia group and the nonhypophosphatemia group according to the serum phosphorus test values obtained three times within 1 week after admission. The incidence of complications during hospitalization, 28-day mortality, and 6-month mRS score were compared between the two groups. The influence of low phosphorus in patients with hypophosphatemia on the 6-month mRS score was explored.

Results

A total of 133 patients were included, of which 85 had hypophosphatemia. Forty-two patients (21 in the hypophosphatemia group and 21 in the nonhypophosphatemia group) were enrolled after propensity score matching. There were no statistically significant differences in the incidence of complications during hospitalization, 28-day mortality, and 6-month mRS score between the two groups (P > 0.05). In 85 patients with hypophosphatemia, the minimum serum phosphorus was associated with the 6-month mRS score (B =  − 3.153, 95% CI: − 5.842 ~  − 0.463, P = 0.022). The cutoff value of serumphosphorus for predicting 6-month mRS score was 0.505 mmol/l.

Conclusion

Whether hypophosphatemia occurred during hospitalization in patients with spontaneous intracerebral hemorrhage showed no effect on the incidence of complications, 28-day mortality, and 6-month mRS score. A significant decrease in serum phosphorus during hospitalization (≤ 0.505 mmol/l) might correlate with a poor 6-month mRS score. Maintaining serum phosphorus stability after spontaneous intracerebral hemorrhage may improve prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Pinho J, Costa AS, Araujo JM, Amorim JM, Ferreira C (2019) Intracerebral hemorrhage outcome: a comprehensive update. J Neurol Sci 398:54–66

    Article  PubMed  Google Scholar 

  2. Coulden AE, Rickard LJ, Crooks N, Arora N (2018) Phosphate replacement in the critically ill: potential implications for military patients. J R Army Med Corps 164(2):112–115

    Article  CAS  PubMed  Google Scholar 

  3. Junttila E, Koskenkari J, Ala-Kokko T (2017) Hypophosphatemia after nontraumatic intracranial hemorrhage. Acta Anaesthesiol Scand 61(6):641–649

    Article  CAS  PubMed  Google Scholar 

  4. Erritzoe-Jervild M, Wesierski J, Romano S et al (2021) Hypophosphataemia is common in patients with aneurysmal subarachnoid haemorrhage. Acta Anaesthesiol Scand 65(10):1431–1438

    Article  PubMed  Google Scholar 

  5. Loggini A, El Ammar F, Mansour A, Kramer CL, Goldenberg FD, Lazaridis C (2021) Association between electrolyte levels at presentation and hematoma expansion and outcome in spontaneous intracerebral hemorrhage: a systematic review. J Crit Care 61:177–185

    Article  CAS  PubMed  Google Scholar 

  6. Brott T, Adams HP Jr, Olinger CP, et al (1989) Measurements of acute cerebral infarction: a clinical examination scale. Stroke 20(7):864–870

    Article  CAS  PubMed  Google Scholar 

  7. Sulter G, Steen C, De Keyser J (1999) Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke 30(8):1538–1541

    Article  CAS  PubMed  Google Scholar 

  8. Berger MM, Appelberg O, Reintam-Blaser A et al (2021) Prevalence of hypophosphatemia in the ICU - results of an international one-day point prevalence survey. Clin Nutr 40(5):3615–3621

    Article  CAS  PubMed  Google Scholar 

  9. Florenzano P, Cipriani C, Roszko KL et al (2020) Approach to patients with hypophosphataemia. Lancet Diabetes Endocrinol 8(2):163–174

    Article  CAS  PubMed  Google Scholar 

  10. Leung J, Crook M (2019) Disorders of phosphate metabolism. J Clin Pathol 72(11):741–747

    Article  CAS  PubMed  Google Scholar 

  11. Koumakis E, Cormier C, Roux C, Briot K (2021) The causes of hypo- and hyperphosphatemia in humans. Calcif Tissue Int 108(1):41–73

    Article  CAS  PubMed  Google Scholar 

  12. Sin JCK, King L, Ballard E, Llewellyn S, Laupland KB, Tabah A (2021) Hypophosphatemia and outcomes in ICU: a systematic review and meta-analysis. J Intensive Care Med 36(9):1025–1035

    Article  PubMed  Google Scholar 

  13. Thongprayoon C, Cheungpasitporn W, Chewcharat A et al (2022) Hospital-acquired serum phosphate derangements and their associated in-hospital mortality. Postgrad Med J 98(1155):43–47

    PubMed  Google Scholar 

  14. Christov M, Juppner H (2018) Phosphate homeostasis disorders. Best Pract Res Clin Endocrinol Metab 32(5):685–706

    Article  CAS  PubMed  Google Scholar 

  15. Reintam Blaser A, Gunst J, Ichai C et al (2021) Hypophosphatemia in critically ill adults and children - a systematic review. Clin Nutr 40(4):1744–1754

    Article  CAS  PubMed  Google Scholar 

  16. Wang L, Xiao C, Chen L, Zhang X, Kou Q (2019) Impact of hypophosphatemia on outcome of patients in intensive care unit: a retrospective cohort study. BMC Anesthesiol 19(1):86

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Narayan A, Subramanian A (2018) Severe hypophosphataemia: a rare cause of postoperative muscle weakness. BMJ Case Rep 2018:bcr2017221193.

  18. Pesta DH, Tsirigotis DN, Befroy DE et al (2016) Hypophosphatemia promotes lower rates of muscle ATP synthesis. FASEB J 30(10):3378–3387

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hong Y, Wang XH, Xiong YT, Li J, Liu CF (2021) Association between admission serum phosphate level and all-cause mortality among patients with spontaneous intracerebral hemorrhage. Risk Manag Healthc Policy 14:3739–3746

    Article  PubMed  PubMed Central  Google Scholar 

  20. You S, Han Q, Xu J et al (2016) Serum calcium and phosphate levels and short- and long-term outcomes in acute intracerebral hemorrhage patients. J Stroke Cerebrovasc Dis 25(4):914–920

    Article  PubMed  Google Scholar 

  21. Haglin L (2016) Using phosphate supplementation to reverse hypophosphatemia and phosphate depletion in neurological disease and disturbance. Nutr Neurosci 19(5):213–223

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the National Natural Science Foundation of China (82030036 to Hua Feng) and the State Key Laboratory of Trauma, Burn and Combined Injury (SKLYQ202002 to Yujie Chen).

Author information

Author notes

  1. Minglian He and Min Cui contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Shapingba District, 29 Gaotanyan Street, 400038, Chongqing, China

    Minglian He, Jie Lin, Wenyan Li, Fei Li, Yujie Chen, Binbin Tan & Hua Feng

  2. Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China

    Minglian He, Jie Lin, Wenyan Li, Fei Li, Yujie Chen, Binbin Tan & Hua Feng

  3. Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China

    Minglian He, Jie Lin, Wenyan Li, Fei Li, Yujie Chen, Binbin Tan & Hua Feng

  4. Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, 400014, China

    Min Cui & Yongbing Deng

Authors
  1. Minglian He
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Min Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jie Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wenyan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fei Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yujie Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yongbing Deng
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Binbin Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hua Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and experimental design: all authors.

Acquisition of data: Minglian He, Lin Jie.

Analysis and interpretation of data: all authors.

Drafting the article: Minglian He, Min Cui.

Critically revising the article: all authors.

Study supervision: all authors.

Corresponding authors

Correspondence to Binbin Tan or Hua Feng.

Ethics declarations

Ethical approval

Ethical approval of the study was approved by the Ethics Committee of our institution.

Informed consent

None.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, M., Cui, M., Lin, J. et al. Effect of hypophosphatemia on prognosis after spontaneous intracerebral hemorrhage: a retrospective study. Neurol Sci 43, 6871–6879 (2022). https://doi.org/10.1007/s10072-022-06358-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-022-06358-4

Keywords

Search

Navigation