ArticleEndocrine2017
Calcium levels on admission and before discharge are associated with mortality risk in hospitalized patients.
Article in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hypocalcemia is associated with severe COVID-19: A systematic review and meta-analysis.Diabetes & metabolic syndromePooled it
- Severe hypocalcemia in the emergency department: a retrospective cohort study of prevalence, etiology, treatment and outcome.Internal and emergency medicine · 2025Article
- Emergencies in Hematology: Why, When and How I Treat?Journal of clinical medicine · 2024Review
- Serum total calcium levels as a non-linear predictor of in-hospital mortality in heart failure patients: insights from a retrospective cohort study.BMC cardiovascular disorders · 2024Article
- Association between serum calcium and in-hospital mortality in critically ill atrial fibrillation patients from the MIMIC IV database.Scientific reports · 2024Article
- U-shaped association between serum calcium and in-hospital mortality in diabetes patients with congestive heart failure: a cohort study.Scientific reports · 2024Article
- COVID-19-Induced Refractory Symptomatic Hypocalcemia in a Patient With Parathyroid Gland Reimplantation.Case reports in endocrinology · 2024Article
- The Relationship between Planar and SPECT/CT Parameters and Functional Markers in Primary Hyperparathyroidism.Diagnostics (Basel, Switzerland) · 2023Article
- Clinical Profile and Outcomes of Patients With Hypercalcemia in an Indian Tertiary Care Center.Cureus · 2023Article
- Role of arterial blood gas (ABG) as a valuable assessment tool of disease severity in SARS-CoV-2 patients.Journal of medical biochemistry · 2022Article
- Effect of Admission Serum Calcium Levels and Length of Stay in Patients with Acute Pancreatitis: Data from the MIMIC-III Database.Emergency medicine international · 2022Article
- Clinical Features and Factors Associated With Sepsis-Associated Encephalopathy in Children: Retrospective Single-Center Clinical Study.Frontiers in neurology · 2022Article
- Epidemiological Characteristics of Hospitalized Patients with Moderate versus Severe COVID-19 Infection: A Retrospective Cohort Single Centre Study.Diseases (Basel, Switzerland) · 2021Article
- Diagnosis and prediction of COVID-19 severity: can biochemical tests and machine learning be used as prognostic indicators?Computers in biology and medicine · 2021Article
- Serum Calcium and Vitamin D levels: Correlation with severity of COVID-19 in hospitalized patients in Royal Hospital, Oman.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Observational
- The Prognostic Value of Calcium in Post-Cardiovascular Surgery Patients in the Intensive Care Unit.Frontiers in cardiovascular medicine · 2021Article
- Hypocalcemia is a distinctive biochemical feature of hospitalized COVID-19 patients.Endocrine · 2021Article
- Hospital-Acquired Serum Ionized Calcium Derangements and Their Associations with In-Hospital Mortality.Medicines (Basel, Switzerland) · 2020Article
- Hypocalcemia is highly prevalent and predicts hospitalization in patients with COVID-19.Endocrine · 2020Article
- Impact of Changes in Serum Calcium Levels on In-Hospital Mortality.Medicina (Kaunas, Lithuania) · 2020Article
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Abstract
aimInvestigate the association of calcium levels on admission and change in levels during hospitalization with hospitalization outcomes.
methodsHistorical prospective data of patients hospitalized to units of internal medicine between 2011 and 2013. Albumin-corrected-calcium levels were classified to marked hypocalcemia (<7.5 mg/dL), mild hypocalcemia (7.5-8.5 mg/dL), normal calcium (8.5-10.5 mg/dL), mild hypercalcemia (10.5-11.5 mg/dL), marked hypercalcemia (>11.5 mg/dL). Main outcomes were length-of-hospitalization, in-hospital and long-term mortality.
resultsCohort included 30,813 patients (mean age 67 ± 18 years, 51% male). Follow-up (median ± standard deviation) was 1668 ± 325 days. Most patients had normal calcium on admission (93%), 3% had hypocalcemia, 3% had hypercalcemia. Common causes for marked hypercalcemia were malignancy (56%) and hyperparathyroidism (22%). Last calcium levels before discharge or death were normal in 94%, with similar rates of hypercalcemia or hypocalcemia (3% each). Compared to in-hospital mortality with normal calcium on admission (6%), mortality was higher with mild (8%) and marked hypocalcemia (11%), and highest with mild (18%) and marked hypercalcemia (22%). Mortality rate at the end of follow-up was 48% with normal calcium or mild hypocalcemia, 51% with marked hypocalcemia, 68 and 79% with mild and marked hypercalcemia, respectively. Patients with normal calcium on admission and before discharge had the best prognosis. Hypercalcemia on admission or before discharge was associated with a 70% mortality risk at the end of follow-up. Normalization of admission hypercalcemia had no effect on long-term mortality risk.
conclusionsAbnormal calcium on admission is associated with increased short-term and long-term mortality. The excess mortality risk is higher with hypercalcemia than hypocalcemia. Calcium normalization before discharge had no effect on mortality.
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