Admission Serum Calcium Level and Short-Term Mortality After Acute Ischemic Stroke: A Secondary Analysis Based on a Norwegian Retrospective Cohort

Lu, Yuzhao; Ma, Xin; Tazmini, Kiarash; Han, Yachun; Zhou, Xiaobing; Wang, Yan

doi:10.3389/fneur.2022.889518

Cited by 7 publications

(8 citation statements)

References 40 publications

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“…[35] In addition, calcium is an important intracellular messenger that plays a key role in neuronal damage and cell death; mitochondrial damage caused by high calcium concentrations may be another mechanism. [36,37] Total serum calcium(TSC) is one of the most important cations in the body and plays a key role in almost all biological processes. TSC certainly plays a role in the pathogenesis of ischemic stroke by influencing the cycle of cytotoxic events that result in ischemic cell death.…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width to total serum calcium ratio and in-hospital mortality risk in patients with acute ischemic stroke: A MIMIC-IV retrospective analysis

Zhang,

Shen,

Zhou

et al. 2024

Medicine

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We investigated the relationship among red cell distribution width (RDW), to total serum calcium (TSC) ratio (RCR), and in-hospital mortality in patients with acute ischemic stroke (AIS). This study was a retrospective analysis. The data of 2700 AIS patients was retrospectively analyzed from the Medical Information Mart for Intensive Care database (version IV). The main outcome of interest was in-hospital mortality. A Cox proportional hazards regression model was used to determine whether RCR was independently associated with in-hospital mortality. The Kaplan–Meier method was used to plot the survival curves for RCR. Subgroup analyses were performed to measure the mortality across various subgroups. The area under curve (AUC) of receiver operating characteristic curve (ROC) was calculated to ascertain the quality of RCR as a predictor of in-hospital mortality in patients with AIS. In the multivariate analysis, statistically significant differences were identified in age, ethnicity, length of ICU stay, mechanical ventilation, sequential organ failure assessment (SOFA) score, RDW, hemoglobin, RCR, whether taking anticoagulants, hyperlipidemia, and atrial fibrillation (P < .05). A threshold inflection point value of 1.83 was obtained through a two-piecewise regression model. There was a non-linear relationship between RCR and hospital mortality in patients with AIS. The hazard ratio (HR) and the 95% confidence intervals (CI) on the right and left of the inflection point were 0.93 (0.57-1.51; P = .7660) and 2.96 (1.37–6.42; P = .0060), respectively. The Kaplan–Meier curve indicated that survival rates were higher when RCR was ≤ 1.83 and lower when RDW was > 1.83 after adjustment for age, gender, BMI, ethnicity. The area under curve (AUC) of RCR was 0.715. A higher RCR was associated with an increased risk of in-hospital mortality in patients with AIS.

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Section: Discussionmentioning

confidence: 99%

Red cell distribution width to total serum calcium ratio and in-hospital mortality risk in patients with acute ischemic stroke: A MIMIC-IV retrospective analysis

Zhang,

Shen,

Zhou

et al. 2024

Medicine

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“…Ascertainment of all-cause mortality and disease-specific mortality 10.3389/fnut.2022.1097488 from any cause; cardiovascular disease (CVD) mortality was defined as codes I00-I09, I11, I13, I20-I51, and I60-I69 (Supplementary Table 1); cancer mortality was defined as codes C00-C97 (Supplementary Table 2) according to the International Classification of Diseases, 10th Revision (ICD-10) codes recorded as the underlying cause of death.…”

Section: Measurement Of Total Calcium In Serummentioning

confidence: 99%

“…Recently, it has been realized that the altered serum calcium hemostasis may have more clinical significance, than just indicating the dysfunction of calcium metabolism. The association of serum calcium with mortality has been investigated in certain populations, such as patients with chronic heart failure (5), coronary heart disease (6), hemodialysis (7)(8)(9), and ischemic stroke (10). However, the evidence for the association of serum with mortality from the general population is rare and limited.…”

Section: Introductionmentioning

confidence: 99%

L-shaped association of serum calcium with all-cause and CVD mortality in the US adults: A population-based prospective cohort study

Hou

Liu

et al. 2023

Front. Nutr.

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BackgroundCalcium is involved in many biological processes, but the impact of serum calcium levels on long-term mortality in general populations has been rarely investigated.MethodsThis prospective cohort study analyzed data from the National Health and Nutrition Examination Survey (1999–2018). All-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality were obtained through linkage to the National Death Index. Survey-weighted multivariate Cox regression was performed to compute hazard ratios (HRs) and 95% confidential intervals (CIs) for the associations of calcium levels with risks of mortality. Restricted cubic spline analyses were performed to examine the non-linear association of calcium levels with all-cause and disease-specific mortality.ResultsA total of 51,042 individuals were included in the current study. During an average of 9.7 years of follow-up, 7,592 all-cause deaths were identified, including 2,391 CVD deaths and 1,641 cancer deaths. Compared with participants in the first quartile (Q1) of serum calcium level [≤2.299 mmol/L], the risk of all-cause mortality was lower for participants in the second quartile (Q2) [2.300–2.349 mmol/L], the third quartile (Q3) [2.350–2.424 mmol/L] and the fourth quartile (Q4) [≥2.425 mmol/L] with multivariable-adjusted HRs of 0.81 (95% CI, 0.74–0.88), 0.78 (95% CI, 0.71–0.86), and 0.80 (95% CI, 0.73, 0.88). Similar associations were observed for CVD mortality, with HRs of 0.82 (95% CI, 0.71–0.95), 0.87 (95% CI, 0.74–1.02), and 0.83 (95% CI, 0.72, 0.97) in Q2–Q4 quartile. Furthermore, the L-shaped non-linear associations were detected for serum calcium with the risk of all-cause mortality. Below the median of 2.350 mmol/L, per 0.1 mmol/L higher serum calcium was associated with a 24% lower risk of all-cause mortality (HR: 0.76, 95% CI, 0.70–0.83), however, no significant changes were observed when serum calcium was above the median. Similar L-shaped associations were detected for serum calcium with the risk of CVD mortality with a 25% reduction in the risk of CVD death per 0.1 mmol/L higher serum calcium below the median (HR: 0.75, 95% CI, 0.65–0.86).ConclusionL-shaped associations of serum calcium with all-cause and CVD mortality were observed in US adults, and hypocalcemia was associated with a higher risk of all-cause mortality and CVD mortality.

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“…[14] Both hypocalcemia and hypercalcemia are associated with increased short-and long-term mortalities, [15] and abnormalities in serum calcium increase the risk of mortality in diseases such as multiple myeloma, acute ischemic stroke, and cardiovascular disease. [16][17][18] We speculated that both high and low levels of serum calcium may be potential risk factors for death in patients with ARF. However, few studies have explored the relationship between RDW to calcium ratio (RDW/CA), and patient mortality.…”

Section: Introductionmentioning

confidence: 99%

The relationship between red cell distribution width, serum calcium ratio, and in-hospital mortality among patients with acute respiratory failure: A retrospective cohort study of the MIMIC-IV database

Dai,

Guo,

Zhou

et al. 2024

Medicine

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To investigate the impact of RDW/CA (the ratio of red cell distribution width to calcium) on in-hospital mortality in patients with acute respiratory failure (ARF). This retrospective cohort study analyzed the data of 6981 ARF patients from the Medical Information Mart for Intensive Care (MIMIC-IV) database 2.0. Critically ill participants between 2008 and 2019 at the Beth Israel Deaconess Medical Center in Boston. The primary outcome of interest was in-hospital mortality. A Cox proportional hazards regression model was used to determine whether the RDW/CA ratio independently correlated with in-hospital mortality. The Kaplan–Meier method was used to plot the survival curves of the RDW/CA. Subgroup analyses were performed to measure the mortality across various subgroups. After adjusting for potential covariates, we found that a higher RDW/CA was associated with an increased risk of in-hospital mortality (HR = 1.17, 95% CI: 1.01–1.35, P = .0365) in ARF patients. A nonlinear relationship was observed between RDW/CA and in-hospital mortality, with an inflection point of 1.97. When RDW/CA ≥ 1.97 was positively correlated with in-hospital mortality in patients with ARF (HR = 1.554, 95% CI: 1.183–2.042, P = .0015). The Kaplan–Meier curve indicated the higher survival rates for RDW/CA < 1.97 and the lower for RDW/CA ≥ 1.97 after adjustment for age, gender, body mass index, and ethnicity. RDW/CA is an independent predictor of in-hospital mortality in patients with ARF. Furthermore, a nonlinear relationship was observed between RDW/CA and in-hospital mortality in patients with ARF.

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Admission Serum Calcium Level and Short-Term Mortality After Acute Ischemic Stroke: A Secondary Analysis Based on a Norwegian Retrospective Cohort

Cited by 7 publications

References 40 publications

Red cell distribution width to total serum calcium ratio and in-hospital mortality risk in patients with acute ischemic stroke: A MIMIC-IV retrospective analysis

Red cell distribution width to total serum calcium ratio and in-hospital mortality risk in patients with acute ischemic stroke: A MIMIC-IV retrospective analysis

L-shaped association of serum calcium with all-cause and CVD mortality in the US adults: A population-based prospective cohort study

The relationship between red cell distribution width, serum calcium ratio, and in-hospital mortality among patients with acute respiratory failure: A retrospective cohort study of the MIMIC-IV database

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