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Association between admission serum calcium and hemoglobin in older patients with hip fracture: a cross-sectional
Zhicong Wang1, Xi Chen1, Yan Chen1
1Orthopedic Center of Deyang City, Department of Orthopedic Surgery, People's Hospital of Deyang City, Deyang, 618000, Sichuan, China.
Insights
Hypocalcaemia is common in older adults with hip fractures and is linked to lower hemoglobin levels. This study found a positive association between low calcium and low hemoglobin in these patients.
Area of Science:
- Geriatric Medicine
- Hematology
- Orthopedics
Background:
- Serum calcium is vital for blood coagulation.
- Low calcium levels are linked to increased bleeding in various conditions.
- Older patients with hip fractures are a vulnerable population with potential co-existing conditions.
Purpose of the Study:
- To determine the prevalence of hypocalcaemia in older patients with hip fractures.
- To investigate the correlation between serum calcium and hemoglobin (Hb) levels in this demographic.
Main Methods:
- Utilized data from a hip fracture database (2014-2020).
- Corrected serum calcium for albumin levels; defined hypocalcaemia (<2.11 mmol/L).
- Employed Pearson correlation and partial correlation analyses to assess associations with Hb.
Main Results:
- Included 1032 older patients (mean age 79.2 years, 66% female).
- Prevalence of hypocalcaemia was 39.5%; anemia was 71.6%.
- Low serum calcium positively correlated with low Hb (r=0.13, P<0.001) after adjustments.
Conclusions:
- Hypocalcaemia is prevalent in older hip fracture patients.
- Low calcium levels are independently associated with low hemoglobin.
- Further research is needed to establish a causal link between calcium and Hb.
Purpose:
Serum calcium ion is an essential cofactor in the coagulation cascade, and low calcium concentration is associated with more bleeding in many diseases. This study aimed to describe the prevalence of hypocalcaemia, and investigate the correlation between calcium and hemoglobin (Hb) level in older patients with hip fracture.
Methods:
From our established hip fracture database, patients were consecutively included between January 2014 and December 2020. Serum calcium concentration was corrected for albumin level, and hypocalcaemia was defined as corrected calcium below the lower limit of reference range (< 2.11 mmol/L), and further sub-grouped into mild hypocalcaemia (1.90-2.11 mmol/L) and severe hypocalcaemia (< 1.90 mmol/L). Pearson correlation, scatter plots and partial correlation analyses were performed to evaluate the associations between various factors and Hb level.
Results:
A total of 1032 older patients with hip fracture were finally included (mean age 79.2 years, 66.0% female). At admission, the mean serum corrected calcium and Hb levels were 2.14 mmol/L and 11.0 g/dL. Overall, the prevalence of hypocalcaemia and anemia were 39.5% and 71.6%, respectively. After adjusting for all variables, low serum calcium concentration was positively associated with low Hb level in the total study (partial correlation r = 0.13, P < 0.001), as well as in patients with femur neck fracture (partial correlation r = 0.16, P = 0.001) and intertrochanteric fracture (partial correlation r = 0.13, P = 0.003).
Conclusion:
Hypocalcaemia was common in older patients with hip fracture, and independently and positively associated with low Hb level. Further study on causal relationship between calcium and Hb level in older patients with hip fracture is necessary.
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