ArticleBMJ open2020
Serum ionised calcium and the risk of acute respiratory failure in hospitalised patients: a single-centre cohort study in the USA.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 23 citations in OpenAlex.
- Factors associated with postoperative respiratory failure in hospitalized patients with thoracolumbar fractures: a retrospective cross-sectional study based on the MIMIC-IV database.Journal of thoracic disease · 2026Article
- Association of the red cell distribution width to total serum calcium ratio with severe AKI in patients undergoing cardiac surgery: a retrospective cohort study using the MIMIC-IV database.Journal of cardiothoracic surgery · 2026Observational
- Can Ionized Calcium Levels Differentiate Acute Anemia and Chronic Anemia in Patients Transfused in the Emergency Department?Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Association between serum calcium levels and the risk of invasive mechanical ventilation in COPD: a retrospective cohort study.Frontiers in medicine · 2025Article
- A New Predictive Equation for Estimating Serum Ionized Calcium Levels in Patients on Chronic Hemodialysis.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study.Journal of laboratory physicians · 2023Article
- Intensive Care Unit-Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2023Review
- Ionised hypocalcaemia in emergency and acute medicine.BMJ case reports · 2022Article
- Prognosis assessment model based on low serum calcium in patients with acute pulmonary thromboembolism.Respirology (Carlton, Vic.) · 2022Observational
- Development and Validation of a Personalized Model With Transfer Learning for Acute Kidney Injury Risk Estimation Using Electronic Health Records.JAMA network open · 2022Article
- 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
- Impact of admission serum ionized calcium levels on risk of acute kidney injury in hospitalized patients.Scientific reports · 2020Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe objective of this study was to evaluate the risk of acute respiratory failure in all hospitalised patients based on admission serum ionised calcium.
designA retrospective cohort study.
settingA tertiary referral hospital in Rochester, Minnesota, USA.
participantsAll hospitalised patients who had serum ionised calcium measurement within 24 hours of hospital admission from January 2009 to December 2013. Patients who were mechanically ventilated at admission were excluded. PREDICTORS: Admission serum ionised calcium levels was stratified into six groups: ≤4.39, 4.40-4.59, 4.60-4.79, 4.80-4.99, 5.00-5.19 and ≥5.20 mg/dL. PRIMARY OUTCOME MEASURE: The primary outcome was the development of acute respiratory failure requiring mechanical ventilation during hospitalisation. Logistic regression analysis was fit to assess the independent risk of acute respiratory failure based on various admission serum ionised calcium, using serum ionised calcium of 5.00-5.19 mg/dL as the reference group.
resultsOf 25 709 eligible patients, with the mean serum ionised calcium of 4.8±0.4 mg/dL, acute respiratory failure requiring mechanical ventilation occurred in 2563 patients (10%). The incidence of acute respiratory failure was lowest when admission serum ionised calcium was 5.00-5.19 mg/dL, with the progressively increased risk of acute respiratory failure with decreased serum ionised calcium. In multivariate analysis with adjustment for potential confounders, the increased risk of acute respiratory failure requiring mechanical ventilation was significantly associated with admission serum ionised calcium of ≤4.39 (OR 2.52; 95% CI 2.12 to 3.00), 4.40-4.59 (OR 1.76; 95% CI 1.49 to 2.07) and 4.60-4.79 mg/dL (OR 1.48; 95% CI 1.27 to 1.72), compared with serum ionised calcium of 5.00-5.19 mg/dL. The risk of acute respiratory failure was not significantly increased when serum ionised calcium was at least 4.80 mg/dL.
conclusionThe increased risk of acute respiratory failure requiring mechanical ventilation was observed when admission serum ionised calcium was lower than 4.80 mg/dL in hospitalised patients.
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