Search Results (3)

Objectives: On-admission phosphate imbalance (OAPI) in traumatic brain injury (TBI) is scarce in the literature, either alone or with concomitant spinal injuries (CSI). We aimed to explore the OAPI in TBI and hypothesized that OAPI has unfavorable outcomes in TBI as well as spinal injury. Methods: In this retrospective study, all hospitalized patients with TBI were reviewed, and their serum phosphate levels were measured upon admission. Outcomes included in-hospital mortality and neurological deficit. Results: Among 912 TBI patients, 13% had hyperphosphatemia (n = 118/912) and 30% had associated CSI (n = 272/912). Hypophosphatemia was found in two-thirds of TBI patients (n = 607/912). Thirteen patients of CSI group developed neurological deficits (4.8%) with hypophosphatemia. Serum phosphate levels were significantly correlated with serum potassium, magnesium, and lactate levels, as well as Injury Severity Score (ISS). The serum glucose-phosphate ratio was higher in patients with severe Glasgow Coma Scale (GCS). The overall mortality was 21.3% (47% had hyperphosphatemia, 17% had hypophosphatemia, and 18% had normophosphatemia). Multivariable analysis showed that hyperphosphatemia, high serum lactate, sodium, and potassium levels, high head Abbreviated Injury Scale (AIS), and low GCS were significantly associated with increased mortality. Conclusions: Hypophosphatemia was common in TBI patients regardless of the presence of spinal injuries and was observed in all patients with neurological deficits. Routine phosphate monitoring may help in early risk stratification and targeted management of TBI. Full article

Background and Objectives: The risk of developing glycemic dysregulation up to overt diabetes mellitus (DM) after an episode of acute pancreatitis (AP) is increasingly being analyzed. We aimed to assess the changes in serum glucose levels associated with the first episode of AP, as well as the impact of dysglycemia on outcomes such as the severity of inflammation, the length of hospitalization, mortality, and the persistence of hyperglycemia at follow-up. Materials and Methods: All patients experiencing their first episode of AP, who presented to the Emergency Room (ER) between 1 January 2020 and 31 December 2023, were retrospectively included. On-admission serum glucose and peak serum glucose during hospitalization were the biological markers used to assess glucose metabolism impairment, and they were correlated with outcomes of AP. Results: Our study included 240 patients, 46.67% (112 patients) having a biliary etiology for an AP flare. Patients with COVID-19-associated AP exhibited the highest on-admission and peak serum glucose levels (244.25 mg/dL and 305.5 mg/dL, respectively). A longer hospital stay was noted in patients with peak serum glucose levels of ≥100 mg/dL (9.49 days) compared to normoglycemic patients (6.53 days). Both on-admission and peak glucose levels were associated with elevated CRP levels during hospitalization. A total of 83.78% of patients who received antibiotics exhibited on-admission hyperglycemia, and 72.07% had peak serum glucose levels of ≥100 mg/dL. The presence of hyperglycemia at follow-up was associated with both on-admission and peak serum glucose levels of ≥100 mg/dL, as well as with a longer stay, higher CRP levels, and antibiotic use during index admission. Conclusions: On-admission hyperglycemia predicts a higher inflammatory response in patients at the first episode of AP, while the presence of hyperglycemia during hospitalization is associated with imaging and biological severity and longer hospitalizations, indicating a more severe disease course. Both on-admission and peak in-hospital hyperglycemia were identified as risk factors for sustained hyperglycemia at follow-up. Full article

(1) Background: This study aimed to analyze if the serum albumin levels of hospitalized SARS-CoV-2 (COVID-19) patients on admission could predict <30 days in-hospital all-cause mortality, and if glucose levels on admission affected this predictive ability. (2) Methods: A multicenter retrospective cohort of 1555 COVID-19-infected adult patients from public hospitals of the Madrid community were analyzed. (3) Results: Logistic regression analysis showed increased mortality for ages higher than 49 y. After adjusting for age, comorbidities and on-admission glucose levels, it was found that on-admission serum albumin ≥3.5 g/dL was significantly associated with reduced mortality (OR 0.48; 95%CI:0.36–0.62). There was an inverse concentration-dependent association between on-admission albumin levels and <30 days in-hospital all-cause mortality. However, when on-admission glucose levels were above 125 mg/dL, higher levels of serum albumin were needed to reach an association with survival. In vitro experiments showed that the spike protein S1 subunit of SARS-CoV-2 binds to native albumin. The binding ability of native albumin to the spike protein S1 subunit was decreased in the presence of an increasing concentration of glycated albumin. (4) Conclusions: On-admission serum albumin levels were inversely associated with <30 days in-hospital all-cause mortality. Native albumin binds the spike protein S1 subunit, suggesting that native albumin may act as a scavenger of the SARS-CoV-2 virus. Full article