Evidence map›Paper›PMID 40696389›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025

Correlates of incident hypocalcemia amongst trauma patients in the Western Cape of South Africa: a secondary analysis of the Epidemiology and Outcomes of Prolonged Trauma Care (EpiC) study.

Jessica B Oudakker, Christiaan A Rees, George Oosthuizen, Elmin Steyn, Shaheem de Vries, Janette Verster, Craig Wylie, Mohammed Mayet, Lesley Hodsdon, Karlien Doubell and 10 more

Abstract read
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In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Jessica B Oudakker *Center for Combat and Battlefield (COMBAT) Research, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
Christiaan A Rees *Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
George OosthuizenDivision of Surgery, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa.
Elmin SteynDivision of Surgery, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa.
Shaheem de VriesCollaborative for Emergency Care in Africa, Cape Town, South Africa.
Janette VersterDivision of Forensic Medicine, Department of Pathology, Stellenbosch University, Cape Town, South Africa.
Craig WylieWestern Cape Government Health and Wellness, Cape Town, South Africa.
Mohammed MayetWestern Cape Government Health and Wellness, Cape Town, South Africa.
Lesley HodsdonWestern Cape Government Health and Wellness, Cape Town, South Africa.
Karlien DoubellWestern Cape Government Health and Wellness, Cape Town, South Africa.
Leigh WagnerWestern Cape Government Health and Wellness, Cape Town, South Africa.
L'Oreal SnydersWestern Cape Government Health and Wellness, Cape Town, South Africa.
Denise LourensWestern Cape Government Health and Wellness, Cape Town, South Africa.
Julia M DixonDepartment of Emergency Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, 12631 E. 17th Ave, Room 2601, MS C326, Aurora, CO, 80045, USA.
Jessica L WildDepartment of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, USA.
Mengli XiaoDepartment of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, USA.
Lani FinckDepartment of Emergency Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, 12631 E. 17th Ave, Room 2601, MS C326, Aurora, CO, 80045, USA.
Steven G SchauerCenter for Combat and Battlefield (COMBAT) Research, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
Hendrick J Lategan *Division of Surgery, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa.
Nee-Kofi Mould-Millman *Department of Emergency Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, 12631 E. 17th Ave, Room 2601, MS C326, Aurora, CO, 80045, USA. Nee-Kofi.Mould-Millman@cuanschutz.edu.

Funding

United States Defense Health Agency W81XWH-20-2-0042
6 · The paper itself

Abstract

backgroundDerangements in ionized calcium are common following trauma, with prior research describing an association between hypocalcemia and adverse outcomes such as mortality, coagulopathy severity, and transfusion requirement. The present study evaluates clinical characteristics of patients presenting to emergency care with ionized calcium derangements following severe trauma in a low-resource practice setting.

methodsPatients presenting to emergency care throughout the Western Cape of South Africa following severe traumatic injury (excluding patients with severe traumatic brain injury) for whom an ionized calcium level was measured are included. Patients were stratified according to initial ionized calcium, and characteristics of the different strata (demographics, injury characteristics, and initial serum biomarkers) were compared. Linear and quadratic regression was used to evaluate the relationship between initial ionized calcium and selected laboratory markers such as hemoglobin, lactate, venous pH, and platelets.

results1989 subjects were included. The median initial ionized calcium was 1.14 mmol/L (IQR: 1.09–1.19 mmol/L). 51% of patients were hypocalcemic (< 1.15 mmol/L), and 1.0% hypercalcemic (> 1.29 mmol/L) on presentation. Differences were observed between ionized calcium strata with respect to age (p < 0.01), injury body region (p = 0.02), maximum abbreviated injury scale (AIS) score (p = 0.03), and shock index (p = 0.05). There was a statistically significant relationship between initial ionized calcium and both platelets (p < 0.01) and hemoglobin (p = 0.03) when treating ionized calcium as a quadratic (U-shaped) variable.

conclusionsDerangements in ionized calcium following acute trauma are associated with injury severity (as defined by maximum AIS score) and injury body region, as well as a subset of other laboratory values, including platelet count and hemoglobin. It is notable that the relationship between these variables was parabolic, suggesting that both extremes of ionized calcium derangements are associated with derangements in other serum markers.

trial registrationNot applicable to this study.

Indexed as

HypocalcemiaWounds and InjuriesAdultCalciumFemaleHumansIncidenceInjury Severity ScoreMaleMiddle AgedSouth AfricaCalciumEpidemiologyGlobal healthHypercalcemiaHypocalcemiaTrauma

Identifiers

PMID40696389
PMCPMC12285058

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.