J Int Med Res. 2026 Oct;54(10):3000605261495197. doi: 10.1177/03000605261495197. Epub 2026 Oct 8.
ABSTRACT
ObjectiveThis study aimed to investigate the association between admission serum phosphate levels and clinical outcomes in patients with acute basilar artery occlusion undergoing endovascular treatment.MethodsThis study was a subgroup analysis of the BASILAR registry. In total, 342 patients with acute basilar artery occlusion undergoing endovascular treatment whose admission serum phosphate levels were available were included. Participants were stratified into three groups according to tertiles of admission serum phosphate levels: (a) Tertile 1 (≤0.89 mmol/L); (b) Tertile 2 (0.90-1.09 mmol/L); and (c) Tertile 3 (>1.09 mmol/L). The primary outcome was a modified Rankin Scale score of 0-2 at 90 days. Safety outcomes included 90-day mortality and symptomatic intracranial hemorrhage within 48 h.ResultsIn total, 342 eligible patients were included and stratified into three groups based on serum phosphate level tertiles. Compared with Tertile 1, patients in Tertile 3 (adjusted odds ratio: 3.04, 95% confidence interval: 1.39-6.66, p = 0.006) and Tertile 2 (adjusted odds ratio: 2.61, 95% confidence interval: 1.21-5.66, p = 0.015) had significantly higher odds of achieving modified Rankin scale scores of 0-2 at 90 days. No significant differences were observed in mortality or symptomatic intracranial hemorrhage between the three groups. Restricted cubic spline analysis revealed a significant nonlinear, inverted U-shaped association between serum phosphate levels and modified Rankin scale scores of 0-2 (p for nonlinearity = 0.016).ConclusionsAdmission serum phosphate levels within the high-normal range were associated with favorable 90-day clinical outcomes in patients with acute basilar artery occlusion undergoing endovascular treatment, suggesting that serum phosphate level is as a prognostic biomarker in this population.
PMID:42845010 | DOI:10.1177/03000605261495197