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Published on: July 5, 2013
Calcium administration appears not to benefit acute pancreatitis patients with hypocalcemia
Tianao Yan1,2,3, Yifei Ma1,2,3, Zheng Wang1,2,3
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Insights
Calcium therapy does not improve survival for acute pancreatitis patients with hypocalcemia. This treatment is linked to longer hospital and intensive care unit stays without affecting mortality rates.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Internal Medicine
Background:
- Hypocalcemia is a common complication in acute pancreatitis (AP) patients admitted to the intensive care unit (ICU).
- The therapeutic benefits of calcium administration for hypocalcemia in AP patients remain unclear.
- This study investigates the impact of calcium therapy on AP patient outcomes.
Purpose of the Study:
- To determine if calcium therapy improves prognosis in acute pancreatitis patients experiencing hypocalcemia.
- To assess the association between calcium administration and mortality (in-hospital, 28-day, ICU) and length of stay (LOS) in AP patients with hypocalcemia.
Main Methods:
- Retrospective analysis of 807 acute pancreatitis patients with hypocalcemia from the MIMIC-IV database.
- Utilized propensity score matching (PSM) and inverse probability weighting (IPTW) to control for baseline differences.
- Multivariate regression analysis was employed to evaluate the impact of calcium therapy on patient outcomes.
Main Results:
- 620 patients (76.8%) received calcium treatment; 187 did not.
- Calcium therapy showed no significant association with in-hospital, 28-day, or ICU mortality.
- Calcium administration was significantly associated with prolonged hospital LOS (effect estimate: 6.18) and ICU LOS (effect estimate: 1.72).
Conclusions:
- Calcium administration does not benefit acute pancreatitis patients with hypocalcemia regarding mortality.
- Calcium therapy is associated with significantly longer hospital and ICU lengths of stay.
- No benefits were observed in subgroups receiving exclusive parenteral infusion, early calcium therapy, or with varying degrees of hypocalcemia.
Objective:
Hypocalcemia occurs commonly among patients with acute pancreatitis (AP) in the intensive care unit (ICU). Calcium therapy could be used to correct hypocalcemia and maintain calcium levels, but its impact on the prognosis has not been demonstrated. Our study aimed to determine whether calcium therapy could benefit the multiple outcomes of AP patients with hypocalcemia.
Methods:
We extracted 807 AP patients with hypocalcemia from the Beth Israel Deaconess Medical Center (MIMIC-IV) database and performed retrospective analyses. The outcomes were in-hospital, 28 days, ICU mortality, and the length of stay (LOS) in the hospital and ICU. We performed propensity matching (PSM) and inverse probability weighting (IPTW) to balance the baseline differences and conducted multivariate regression to investigate the impact of calcium therapy.
Results:
A total of 620 patients (76.8%) received calcium treatment (calcium group) during hospitalization, while 187 patients (non-calcium group) did not. Patients in the calcium group did not present significant survival differences between groups before and after matching. After including covariates, calcium administration had no association with patients' in-hospital (HR: 1.03, 95% Cl: 0.47-2.27, p = .942), 28 days and ICU mortality and was significantly associated with prolonged length of stay in the hospital (effect estimate: 6.18, 95% Cl: 3.27-9.09, p < .001) and ICU (effect estimate: 1.72, 95% Cl: 0.24-3.20, p < .001). Calcium therapy could not benefit patients in subgroups with exclusive parenteral infusion, early calcium therapy (<48 h), or various degrees of hypocalcemia.
Conclusion:
AP patients with hypocalcemia could not benefit from calcium administration, which has no association with multiple mortality and is significantly associated with prolonged LOS in the hospital and ICU.
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