The Role of Serial Serum Phosphate Levels in Predicting Outcomes in Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

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DR RAMAIAH T; DR VINEETH SAI R; DR PRANEETA VAVILAPALLI; DR SIDDESWARI

The Role of Serial Serum Phosphate Levels in Predicting Outcomes in Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

Authors: DR RAMAIAH T, DR VINEETH SAI R, DR PRANEETA VAVILAPALLI, DR SIDDESWARI

Unique Paper ID: 183465
Volume: 12
Issue: 3
PageNo: 1715-1720

Keywords: Diabetic Ketoacidosis Hyperglycemic Hyperosmolar State Serum Phosphate Hypophosphatemia Prognosis Mortality

Abstract:
Background: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are acute, life-threatening complications of diabetes mellitus associated with significant metabolic and electrolyte disturbances. While many biochemical markers are monitored, the prognostic value of serum phosphate levels in predicting patient outcomes remains a key area of investigation. This study aimed to evaluate the role of serial serum phosphate levels as a predictor of outcome in patients with DKA and HHS. Methods: A cross-sectional study was conducted from July 2022 to June 2024, involving 50 patients with type 2 diabetes mellitus admitted with DKA or HHS to the Alluri Sitarama Raju Academy of Medical Sciences, a tertiary care center in Eluru, India. Serial serum phosphate levels were measured at admission and during the hospital stay. Data on demographics, clinical parameters (HbA1c, BMI, RBS), duration of ICU and hospital stay, and mortality were collected. Statistical analysis was performed using chi-square tests, and the sensitivity and specificity of serum phosphate as a prognostic marker were calculated. Results: The mean age of the study population was 43.12 ± 5.8 years, with a male predominance (72%). The mean admission RBS was 631.48 mg/dL, and the mean serum phosphate was 2.9 mg/dL. A significant association was found between hypophosphatemia (serum phosphate <2.5 mg/dL) and adverse outcomes. Mortality was significantly higher in the hypophosphatemic group compared to the normophosphatemic group (p<0.05). Furthermore, patients with hypophosphatemia had a significantly longer duration of both ICU stay (mean 11 vs. 6.75 days, p<0.0001) and total hospital stay (mean 14 vs. 9.75 days, p<0.0001). Low serum phosphate demonstrated a sensitivity of 78.57% and a specificity of 88.89% for predicting mortality. Conclusion: Hypophosphatemia upon admission is a significant predictor of adverse outcomes in patients with DKA and HHS. It is strongly associated with increased mortality, as well as prolonged ICU and hospital stays. Routine monitoring of serial serum phosphate levels can serve as a valuable prognostic tool, helping to risk-stratify patients and guide clinical management in these hyperglycemic emergencies.

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ISSN: 2349-6002
Volume: 12
Issue: 3
PageNo: 1715-1720

The Role of Serial Serum Phosphate Levels in Predicting Outcomes in Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

Available:https://ijirt.org/article?manuscript=183465

07 Aug, 2025

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