Basal elevated serum calcium phosphate product as an independent risk factor for mortality in patients with fractures of the proximal femur—A 20 year observation study

Kovar, Florian M.; Endler, Georg; Wagner, Oswald; Wippel, Andreas; Jaindl, Manuela

doi:10.1016/j.injury.2015.11.033

Cited by 4 publications

(3 citation statements)

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“…During the mean follow-up time of 11.0 months, the investigators demonstrated significantly increased mortality risk among those with elevated admission CaP levels. 40 It is noteworthy that even though the highest mortality rate was observed among patients with admission CaP ≥45 mg 2 /dL 2 , patients with low admission CaP <21 mg 2 /dL 2 , also had a higher mortality in our current study. There are multiple possible explanations for this correlation.…”

Section: Discussioncontrasting

confidence: 41%

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Calcium‐phosphate product and its impact on mortality in hospitalized patients

2019

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Aim This study aimed to assess the relationship between admission Calcium‐phosphate (CaP) and in‐hospital mortality in hospitalized patients. Methods All adult hospitalized patients who had both admission serum calcium and phosphate levels available between years 2009 and 2013 were enrolled. Admission CaP was categorized based on its distribution into six groups (<21, 21–<27, 27–<33, 33 39, 39–<45 and ≥45 mg2/dL2). Multivariate logistic regression was used to assess the association between admission CaP and in‐hospital mortality, using the CaP of 27–<33 mg2/dL2 as the reference group. Results Abut 14 772 patients were included in the analysis. The association between CaP and in‐hospital mortality was U‐shaped with the lowest in‐hospital mortality in CaP of 27–<33 mg2/dL2. After adjusting for potential confounders, both CaP <21 and ≥39 mg2/dL2 were associated with higher in‐hospital mortality. Subgroup analysis demonstrated that the highest in‐hospital mortality risk in both chronic kidney disease (CKD) and non‐CKD patients occurred when CaP ≥ 45 mg2/dL2. Conclusion CaP levels on admission were associated with in‐hospital mortality. Highest mortality risk was observed in hospitalized patients with admission CaP of ≥45 mg2/dL2 in both CKD and non‐CKD patients.

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Section: Discussioncontrasting

confidence: 41%

“…recently conducted a cohort study of 577 patients with fractures of the proximal femur to assess the impact of CaP levels on patient outcomes. During the mean follow‐up time of 11.0 months, the investigators demonstrated significantly increased mortality risk among those with elevated admission CaP levels …”

Section: Discussionmentioning

confidence: 96%

Calcium‐phosphate product and its impact on mortality in hospitalized patients

2019

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“…It is well known that increased serum calcium levels are associated with the risk of cardiovascular events and mortality in the general population [13–18]. Nevertheless, evidence is inconsistent in most hospital-based studies regarding the relationship between serum calcium levels and mortality in patients with cardiac and noncardiac diseases [19–21]. Two studies in China reported that decreased baseline serum calcium levels were associated with a high risk of in-hospital mortality in myocardial infarction patients [6, 9].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Serum Calcium in the Risk Stratification of Midterm Mortality among Patients with Acute Coronary Syndrome

Ding

Sun

et al. 2019

BioMed Research International

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Serum calcium has been reported to be a predictor of short-term prognosis; however, evidence regarding its association with midterm mortality is scarce. We investigated the association between serum calcium levels at admission and midterm mortality in a retrospective cohort of 2594 consecutive patients with acute coronary syndrome (ACS) who presented to the First Affiliated Hospital of Harbin Medical University from November 2014 to December 2016. Patients were assigned to 4 groups according to the quartiles of serum calcium levels (Ca-Q1–4) and were followed longitudinally for the time to all-cause death. During a median follow-up period of 21.8 months (17.5∼29.5, IQR), 124 patients died (4.8%) of all causes. Kaplan–Meier curves showed that the incidence of midterm mortality differed significantly (log-rank P=0.038) among the quartiles of serum calcium levels at admission. After adjustment for the confounders that were significant in the univariate analysis, the hazard ratios for the lowest quartile of serum calcium was 1.86 (95% CI, 1.05–3.31; P=0.033), compared with the third quartile (reference group). A multiple restricted cubic spline regression model suggested a reverse J-shaped association between serum calcium levels and midterm mortality, and the lowest risk of mortality was associated with approximately 2.32 mmol/l of serum calcium. In conclusion, the serum calcium level is an independent predictor of all-cause midterm mortality among ACS patients. Patients with abnormal serum calcium levels at admission need more targeted treatments.

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