Charat Thongprayoon1, Wisit Cheungpasitporn2, Api Chewcharat1, Michael A Mao3, Sorkko Thirunavukkarasu1, Kianoush B Kashani1,4. 1. Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA. 2. Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA. 3. Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL, USA. 4. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Abstract
Background: We conducted a single-center historical cohort study to evaluate the association between admission serum ionized calcium and mortality in hospitalized patients. Methods: We included hospitalized patients from January 2009 to December 2013 who had available serum ionized calcium at the time of admission. We assessed the in-hospital and 1-year mortality risk based on admission serum ionized calcium using multivariate logistic and Cox proportional hazard analysis, respectively. To test non-linear association, we categorized serum ionized calcium into six groups; ≤4.39, 4.40-4.59, 4.60-4.79, 4.80-4.99, 5.00-5.19, ≥5.20 mg/dL and selected serum ionized calcium of 4.80-4.99 mg/dL as a reference group. Results: We studied a total of 33,255 hospitalized patients. The mean admission serum ionized calcium at 4.8 ± 0.4 mg/dL. Hospital and 1-year mortality observed in 1,099 (3%) and 5,239 (15.8%), respectively. We observed a U-shaped association between admission serum ionized calcium and in-hospital and 1-year mortality. Ionized calcium lower threshold for increased in-hospital and 1-year mortality rates was ≤4.59 and ≤4.39 mg/dL, respectively. Ionized calcium upper threshold for increased in-hospital and 1-year mortality rates was ≥5.20 mg/dL. Conclusion: Both hypocalcemia and hypercalcemia were associated with increased short- and long-term mortality with a U-shape relationship.
Background: We conducted a single-center historical cohort study to evaluate the association between admission serum ionizedcalcium and mortality in hospitalized patients. Methods: We included hospitalized patients from January 2009 to December 2013 who had available serum ionizedcalcium at the time of admission. We assessed the in-hospital and 1-year mortality risk based on admission serum ionizedcalcium using multivariate logistic and Cox proportional hazard analysis, respectively. To test non-linear association, we categorized serum ionizedcalcium into six groups; ≤4.39, 4.40-4.59, 4.60-4.79, 4.80-4.99, 5.00-5.19, ≥5.20 mg/dL and selected serum ionizedcalcium of 4.80-4.99 mg/dL as a reference group. Results: We studied a total of 33,255 hospitalized patients. The mean admission serum ionizedcalcium at 4.8 ± 0.4 mg/dL. Hospital and 1-year mortality observed in 1,099 (3%) and 5,239 (15.8%), respectively. We observed a U-shaped association between admission serum ionizedcalcium and in-hospital and 1-year mortality. Ionizedcalcium lower threshold for increased in-hospital and 1-year mortality rates was ≤4.59 and ≤4.39 mg/dL, respectively. Ionizedcalcium upper threshold for increased in-hospital and 1-year mortality rates was ≥5.20 mg/dL. Conclusion: Both hypocalcemia and hypercalcemia were associated with increased short- and long-term mortality with a U-shape relationship.
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Authors: Timo Schmitz; Christian Thilo; Jakob Linseisen; Margit Heier; Annette Peters; Bernhard Kuch; Christa Meisinger Journal: Sci Rep Date: 2021-01-28 Impact factor: 4.379
Authors: Charat Thongprayoon; Wisit Cheungpasitporn; Api Chewcharat; Michael A Mao; Kianoush B Kashani Journal: BMJ Open Date: 2020-03-23 Impact factor: 2.692