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Early Hypercalcemia Is Associated With Mortality in Critically Ill, Transfused Trauma Patients

Ellen R Becker1, Catherine G Pratt1, Jenna N Whitrock1

  • 1Department of Surgery, University of Cincinnati, Cincinnati, Ohio.

The Journal of Surgical Research
|November 13, 2025
PubMed

Insights

Hypercalcemia, or high calcium levels, is linked to increased mortality in trauma patients requiring blood transfusions. This finding highlights the need for further research into the effects of post-injury hypercalcemia.

Area of Science:

  • Trauma critical care
  • Clinical biochemistry
  • Medical research

Background:

  • Calcium derangements are common in trauma patients, particularly those needing resuscitation.
  • While hypocalcemia is linked to poor outcomes, hypercalcemia's impact remains unclear.
  • This study investigates hypercalcemia's association with mortality in transfused trauma patients.

Purpose of the Study:

  • To determine the incidence and impact of hypercalcemia in trauma patients requiring blood transfusion.
  • To test the hypothesis that hypercalcemia is associated with higher mortality in this patient group.

Main Methods:

  • Retrospective review of adult trauma patients receiving blood products within 24 hours.
  • Data collected included demographics, calcium levels, transfusion records, and outcomes.
  • Youden indices identified extreme hypercalcemia; multivariable logistic regression analyzed mortality associations.

Main Results:

  • Extreme hypercalcemia was independently associated with 30-day mortality in multivariable analysis (OR 17.5).
  • Hypercalcemic patients received more calcium chloride and higher blood volumes.
  • Platelet administration after 4 hours also correlated with increased mortality.

Conclusions:

  • Extreme hypercalcemia is an independent predictor of 30-day mortality in transfused trauma patients.
  • Further research is warranted to understand the physiological effects of post-injury hypercalcemia.
Abstract

Keywords:
CalciumHypercalcemiaMortalityTransfusionTrauma

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