Clinical significance of peri-operative change of serum inorganic phosphate levels after moderate-to-major abdominal surgery

Objective To analyze the occurrence and clinical significance of hypophosphatemia after moderate-to-major abdominal surgery. Methods A total of 120 patients who had received moderate to major abdominal surgery and then transferred to the intensive care unit (ICU) from January 2008 to October 2018 were retrospectively analyzed. The peri-operative parameters of serum inorganic phosphate and calcium levels were recorded and analyzed. The incidence of hypophosphatemia after the operation was calculated. The effect of phosphorus-supplement infusion on the complications and mortality within 30 days after the operation were observed. Results After moderate-to-major surgery, the phosphorus concentration significantly decreased [(1.21±0.27) vs. (0.83±0.24)mmol/L, P<0.05]; the incidence of hypophosphatemia was 58.3%, especially in patients with nutritional risk assessed before the operation. The post-operative complications were less in the phosphorus-supplement infusion group than in the control group (17.5% vs. 41.3%, P=0.028). Conclusion The incidence of hypophosphatemia is relatively high after moderate-to-major abdominal surgery, especially in patients with nutritional risks. The treatment of phosphorus-supplement infusion can benefit the patients in their short-term prognosis. Key words: Hypophosphatemia; Critically ill; Nutritional risk