Alcohol-Induced Necrotizing Pancreatitis: A Retrospective Study on Serum Phosphate as a Predictor of Intensive Care Admission.

BACKGROUND: Alcohol-induced acute pancreatitis remains a major cause of hospitalization globally. While most cases resolve without complication, a subset progresses to necrotizing pancreatitis requiring intensive care. Identifying early biochemical predictors of severe disease can improve triage and management. METHODS: We conducted a retrospective observational study at Hazm Mebaireek General Hospital, Qatar, including adult male patients diagnosed with alcohol-induced necrotizing pancreatitis between May 2020 and May 2025. Data were extracted from electronic medical records, including demographic, clinical, biochemical, and radiologic variables. The association between hypophosphatemia (serum phosphate <0.8 mmol/L) and intensive care unit (ICU) admission was explored descriptively. RESULTS: Fifteen patients were included (mean age: 38 years). Hypophosphatemia occurred in 60% of cases and was strongly associated with ICU admission (eight of nine ICU patients, 89%). Common complications included pleural effusion (40%), splenic vein thrombosis (20%), and acute kidney injury (13%). Patients with hypophosphatemia exhibited higher BISAP scores, prolonged hospitalization, and greater morbidity. CONCLUSION: Hypophosphatemia is a frequent finding in alcohol-induced necrotizing pancreatitis and may serve as a simple, inexpensive early marker of disease severity. Routine phosphate measurement upon admission may help identify patients at risk for deterioration and guide timely intervention.