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Calcium Disorders in the Emergency Department: Independent Risk Factors for Mortality

Thomas C Sauter1, Gregor Lindner1, Sufian S Ahmad1

  • 1Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, Switzerland.

Plos One
|July 15, 2015
PubMed

Insights

Both low (hypocalcemia) and high (hypercalcemia) calcium levels in emergency department patients are linked to higher in-hospital mortality. This study highlights the importance of monitoring calcium levels for critically ill patients.

Area of Science:

  • Clinical Medicine
  • Biochemistry
  • Critical Care Medicine

Background:

  • Calcium disorders are prevalent in intensive care units and among patients with chronic kidney disease, correlating with increased morbidity and mortality.
  • The impact of calcium abnormalities on in-hospital mortality in unselected emergency department admissions remains unclear.

Purpose of the Study:

  • To investigate the association between calcium disorders (hypocalcemia and hypercalcemia) and 28-day in-hospital mortality in emergency department admissions.
  • To determine if calcium abnormalities are independent risk factors for mortality in this patient population.

Main Methods:

  • A cross-sectional analysis of 8,270 emergency department admissions from 2010-2011.
  • Comparison of subgroups using Mann-Whitney U-test for demographic and clinical variables.
  • Assessment of associations between calcium disorders and 28-day mortality using Cox proportional hazard regression.

Main Results:

  • Overall mortality was 3.2% (264 deaths).
  • Hypocalcemia (6.13%) and hypercalcemia (6.19%) had significantly higher mortality rates compared to normocalcemia (1.82%).
  • Multivariate analysis identified both hypocalcemia and hypercalcemia as independent risk factors for mortality (HR 2.00 and HR 1.88, respectively).

Conclusions:

  • Both hypocalcemia and hypercalcemia are significantly associated with increased 28-day in-hospital mortality.
  • Calcium level monitoring is crucial for risk stratification in emergency department admissions.
Abstract

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