ArticlePloS one2014
Predictive value of ionized calcium in critically ill patients: an analysis of a large clinical database MIMIC II.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 92 citations in OpenAlex.
- Hypocalcemia is associated with severe COVID-19: A systematic review and meta-analysis.Diabetes & metabolic syndromePooled it
- Forgot calcium? Admission ionized-calcium in two civilian randomized controlled trials of prehospital plasma for traumatic hemorrhagic shock.The journal of trauma and acute care surgery · 2020Trial
- Early versus deferred intravenous calcium in patients with sepsis and ionized hypocalcemia: a target-trial emulation.Journal of intensive care · 2026Article
- Prognostic value of severe hypocalcemia in predicting mortality and transfusion in moderate-to-severe trauma.BMC emergency medicine · 2026Observational
- Association Between Serum Ionized Calcium Levels and Neurological Outcomes in Patients with Out-of-Hospital Cardiac Arrest.Life (Basel, Switzerland) · 2025Article
- Hungry Bone Syndrome After Parathyroidectomy for Secondary Hyperparathyroidism: Pathogenesis and Contemporary Clinical Considerations.Journal of clinical medicine · 2025Review
- The Furosemide Stress Test: A Dynamic Tool for Predicting Acute Kidney Injury Progression in Critical Care Medicine.Journal of clinical medicine · 2025Review
- Parenteral calcium administration and outcomes in critically ill patients with hypocalcemia: A retrospective cohort study.Journal of intensive medicine · 2025Article
- Establishment and validation of a prediction model for acute kidney injury in moderate severe and severe acute pancreatitis patients.European journal of medical research · 2025Article
- Large library docking identifies positive allosteric modulators of the calcium-sensing receptor.Science (New York, N.Y.) · 2024Article
- Serum calcium and mortality in pediatric pneumonia patients admitted to the PICU: a retrospective cohort study.Scientific reports · 2024Article
- Calcium supplementation during trauma resuscitation: a propensity score-matched analysis from the TraumaRegister DGUCritical care (London, England) · 2024Article
- Investigating Potential Correlations between Calcium Metabolism Biomarkers and Periprocedural Clinical Events in Major Cardiovascular Surgeries: An Exploratory Study.Journal of clinical medicine · 2024Article
- Small vs. Large Library Docking for Positive Allosteric Modulators of the Calcium Sensing Receptor.bioRxiv : the preprint server for biology · 2024Article
- Can Patients with Electrolyte Disturbances Be Safely and Effectively Treated in a Hospital-at-Home, Telemedicine-Controlled Environment? A Retrospective Analysis of 267 Patients.Journal of clinical medicine · 2024Article
- Effect Modification of Kidney Function on the Non-linear Association Between Serum Calcium Levels and Cardiovascular Mortality in Korean Adults.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2023Article
- Hypocalcemia is associated with adverse outcomes in patients hospitalized with COVID-19.Endocrine · 2023Article
- Risk Factor Analysis and Prediction of Severe Hypocalcemia after Total Parathyroidectomy without Auto-Transplantation in Patients with Secondary Hyperparathyroidism.International journal of endocrinology · 2023Article
- Surgical Treatment for Empyema Thoracis: Prognostic Role of Preoperative Transthoracic Echocardiography and Serum Calcium.Journal of personalized medicine · 2022Article
- Predictive Value of Ionized Calcium for Prognosis of Sepsis in Very Low Birth Weight Infants.Journal of inflammation research · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveIonized calcium (iCa) has been investigated for its association with mortality in intensive care unit (ICU) patients in many studies. However, these studies are small in sample size and the results are conflicting. The present study aimed to establish the association of iCa with mortality by using a large clinical database.
methodsMultiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) database was used for analysis. Patients older than 15 years were eligible, and patients without iCa measured during their ICU stay were excluded. Demographic data and clinical characteristics were extracted and compared between survivors and non-survivors. iCa measure on ICU admission was defined as Ca0; Camax was the maximum iCa during ICU stay; Camin was the minimum value of iCa during the ICU stay; Camean was the arithmetic mean iCa during ICU stay. MAIN
resultsA total of 15409 ICU admissions satisfied our inclusion criteria and were included in our analysis. The prevalence of hypocalcemia on ICU entry was 62.06%. Ca0 was significantly lower in non-survivors than in survivors (1.11 ± 0.14 vs 1.13 ± 0.10 mmol/l, p<0.001). In multivariate analysis, moderate hypocalcemia in Ca0 was significantly associated with increased risk of death (OR: 1.943; 95% CI: 1.340-2.817), and mild hypercalcemia was associated with lower mortality (OR: 0.553, 95% CI: 0.400-0.767). While moderate and mild hypocalcemia in Camean is associated with increased risk of death (OR: 1.153, 95% CI: 1.006-1.322 and OR: 2.520, 95% CI: 1.485-4.278), hypercalcemia in Camean is not significantly associated with ICU mortality.
conclusionThe relationship between Ca0 and clinical outcome follows an "U" shaped curve with the nadir at the normal range, extending slightly to hypercalcemia. Mild hypercalcemia in Ca0 is protective, whereas moderate and mild hypocalcemia in Camean is associated with increased risk of death.
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