Association between Serum Calcium Level and Hemorrhagic Progression in Patients with Traumatic Intraparenchymal Hemorrhage: Investigating the Mediation and Interaction Effects of Coagulopathy

Low serum calcium is a novel predictor of unfavorable prognosis after traumatic brain injury

“…Serum calcium levels can predict prognoses in various diseases, including COVID-19, nasopharyngeal carcinoma, acute pulmonary embolism, and stroke [ 7 , 12 , [23] , [24] , [25] ]. A lower serum calcium level can lead to bleeding, exacerbating secondary injury [ 7 ], and at admission is an independent risk factor for high hematoma volume and acute progression after spontaneous or traumatic ICH [ 12 , 26 ]. Karawan et al noted that mild admission hypocalcemia is associated with better neurological status at discharge in patients with isolated severe TBI [ 27 ].…”

“…Serological ion markers (represented by magnesium ion and phosphonium ion) have shown potential clinical diagnostic and prognostic value in patients with TBI [ 5 ]. Another divalent serum cation, calcium ion, has been shown to be involved in acute parenchymal hematoma progression after TBI or hemorrhagic stroke, potentially by affecting coagulation [ 6 , 7 ]. Notably, intracranial hemorrhage is a common and serious consequence after TBI, and its hematoma progression is associated with neurological deterioration, which in turn leads to poor prognosis in TBI patients [ 8 , 9 ].…”