Impact of Changes in Serum Calcium Levels on In-Hospital Mortality
<i>Background and objectives:</i> Calcium concentration is strictly regulated at both the cellular and systemic level, and changes in serum calcium levels can alter various physiological functions in various organs. This study aimed to assess the association between changes in calcium le...
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doaj-614d9e768abc4f31bb66ca24d10d679f2020-11-25T03:00:58ZengMDPI AGMedicina1010-660X2020-03-0156310610.3390/medicina56030106medicina56030106Impact of Changes in Serum Calcium Levels on In-Hospital MortalityCharat Thongprayoon0Wisit Cheungpasitporn1Panupong Hansrivijit2Juan Medaura3Api Chewcharat4Michael A Mao5Tarun Bathini6Saraschandra Vallabhajosyula7Sorkko Thirunavukkarasu8Stephen B. Erickson9Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADepartment of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA 17101, USADivision of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL 32224, USADepartment of Internal Medicine, University of Arizona, Tucson, AZ 85721, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA<i>Background and objectives:</i> Calcium concentration is strictly regulated at both the cellular and systemic level, and changes in serum calcium levels can alter various physiological functions in various organs. This study aimed to assess the association between changes in calcium levels during hospitalization and mortality. <i>Materials and Methods:</i> We searched our patient database to identify all adult patients admitted to our hospital from January 1st, 2009 to December 31st, 2013. Patients with ≥2 serum calcium measurements during the hospitalization were included. The serum calcium changes during the hospitalization, defined as the absolute difference between the maximum and the minimum calcium levels, were categorized into five groups: 0−0.4, 0.5−0.9, 1.0−1.4, 1.5−1.9, and ≥2.0 mg/dL. Multivariable logistic regression was performed to assess the independent association between calcium changes and in-hospital mortality, using the change in calcium category of 0−0.4 mg/dL as the reference group. <i>Results:</i> Of 9868 patients included in analysis, 540 (5.4%) died during hospitalization. The in-hospital mortality progressively increased with higher calcium changes, from 3.4% in the group of 0−0.4 mg/dL to 14.5% in the group of ≥2.0 mg/dL (<i>p</i> < 0.001). When adjusted for age, sex, race, principal diagnosis, comorbidity, kidney function, acute kidney injury, number of measurements of serum calcium, and hospital length of stay, the serum calcium changes of 1.0−1.4, 1.5−1.9, and ≥2.0 mg/dL were significantly associated with increased in-hospital mortality with odds ratio (OR) of 1.55 (95% confidence interval (CI) 1.15−2.10), 1.90 (95% CI 1.32−2.74), and 3.23 (95% CI 2.39−4.38), respectively. The association remained statistically significant when further adjusted for either the lowest or highest serum calcium. <i>Conclusion:</i> Larger serum calcium changes in hospitalized patients were progressively associated with increased in-hospital mortality.https://www.mdpi.com/1010-660X/56/3/106calciumelectrolyteshypocalcemiahypercalcemiamortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Charat Thongprayoon Wisit Cheungpasitporn Panupong Hansrivijit Juan Medaura Api Chewcharat Michael A Mao Tarun Bathini Saraschandra Vallabhajosyula Sorkko Thirunavukkarasu Stephen B. Erickson |
spellingShingle |
Charat Thongprayoon Wisit Cheungpasitporn Panupong Hansrivijit Juan Medaura Api Chewcharat Michael A Mao Tarun Bathini Saraschandra Vallabhajosyula Sorkko Thirunavukkarasu Stephen B. Erickson Impact of Changes in Serum Calcium Levels on In-Hospital Mortality Medicina calcium electrolytes hypocalcemia hypercalcemia mortality |
author_facet |
Charat Thongprayoon Wisit Cheungpasitporn Panupong Hansrivijit Juan Medaura Api Chewcharat Michael A Mao Tarun Bathini Saraschandra Vallabhajosyula Sorkko Thirunavukkarasu Stephen B. Erickson |
author_sort |
Charat Thongprayoon |
title |
Impact of Changes in Serum Calcium Levels on In-Hospital Mortality |
title_short |
Impact of Changes in Serum Calcium Levels on In-Hospital Mortality |
title_full |
Impact of Changes in Serum Calcium Levels on In-Hospital Mortality |
title_fullStr |
Impact of Changes in Serum Calcium Levels on In-Hospital Mortality |
title_full_unstemmed |
Impact of Changes in Serum Calcium Levels on In-Hospital Mortality |
title_sort |
impact of changes in serum calcium levels on in-hospital mortality |
publisher |
MDPI AG |
series |
Medicina |
issn |
1010-660X |
publishDate |
2020-03-01 |
description |
<i>Background and objectives:</i> Calcium concentration is strictly regulated at both the cellular and systemic level, and changes in serum calcium levels can alter various physiological functions in various organs. This study aimed to assess the association between changes in calcium levels during hospitalization and mortality. <i>Materials and Methods:</i> We searched our patient database to identify all adult patients admitted to our hospital from January 1st, 2009 to December 31st, 2013. Patients with ≥2 serum calcium measurements during the hospitalization were included. The serum calcium changes during the hospitalization, defined as the absolute difference between the maximum and the minimum calcium levels, were categorized into five groups: 0−0.4, 0.5−0.9, 1.0−1.4, 1.5−1.9, and ≥2.0 mg/dL. Multivariable logistic regression was performed to assess the independent association between calcium changes and in-hospital mortality, using the change in calcium category of 0−0.4 mg/dL as the reference group. <i>Results:</i> Of 9868 patients included in analysis, 540 (5.4%) died during hospitalization. The in-hospital mortality progressively increased with higher calcium changes, from 3.4% in the group of 0−0.4 mg/dL to 14.5% in the group of ≥2.0 mg/dL (<i>p</i> < 0.001). When adjusted for age, sex, race, principal diagnosis, comorbidity, kidney function, acute kidney injury, number of measurements of serum calcium, and hospital length of stay, the serum calcium changes of 1.0−1.4, 1.5−1.9, and ≥2.0 mg/dL were significantly associated with increased in-hospital mortality with odds ratio (OR) of 1.55 (95% confidence interval (CI) 1.15−2.10), 1.90 (95% CI 1.32−2.74), and 3.23 (95% CI 2.39−4.38), respectively. The association remained statistically significant when further adjusted for either the lowest or highest serum calcium. <i>Conclusion:</i> Larger serum calcium changes in hospitalized patients were progressively associated with increased in-hospital mortality. |
topic |
calcium electrolytes hypocalcemia hypercalcemia mortality |
url |
https://www.mdpi.com/1010-660X/56/3/106 |
work_keys_str_mv |
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