Next Article in Journal
Pre-Treatment and Post-Treatment Demodex Densities in Patients under Immunosuppressive Treatments
Previous Article in Journal
Estimation of Caries Treatment Needs in First Permanent Molars of Lithuanian 5–6-Year-Old Children, Based on Caries Lesion Activity Assessment
Open AccessArticle

Impact of Changes in Serum Calcium Levels on In-Hospital Mortality

1
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
2
Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
3
Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA 17101, USA
4
Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL 32224, USA
5
Department of Internal Medicine, University of Arizona, Tucson, AZ 85721, USA
6
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
*
Authors to whom correspondence should be addressed.
Medicina 2020, 56(3), 106; https://doi.org/10.3390/medicina56030106
Received: 20 February 2020 / Accepted: 28 February 2020 / Published: 2 March 2020
Background and objectives: 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. Materials and Methods: 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. Results: 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 (p < 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. Conclusion: Larger serum calcium changes in hospitalized patients were progressively associated with increased in-hospital mortality. View Full-Text
Keywords: calcium; electrolytes; hypocalcemia; hypercalcemia; mortality calcium; electrolytes; hypocalcemia; hypercalcemia; mortality
Show Figures

Figure 1

MDPI and ACS Style

Thongprayoon, C.; Cheungpasitporn, W.; Hansrivijit, P.; Medaura, J.; Chewcharat, A.; Mao, M.A.; Bathini, T.; Vallabhajosyula, S.; Thirunavukkarasu, S.; Erickson, S.B. Impact of Changes in Serum Calcium Levels on In-Hospital Mortality. Medicina 2020, 56, 106.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop