Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Sydney Medical School and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
Intern Med J. 2022 Sep;52(9):1596-1601. doi: 10.1111/imj.15402. Epub 2022 Jun 3.
Studies examining hypercalcaemia in inpatients were largely published over 20 years ago, and it is likely the epidemiology of hypercalcaemia has changed related to increased lifespan and changes in the prevalence of the underlying causes such as malignancy.
To explore the epidemiology of hypercalcaemia in a modern tertiary hospital setting in Australia and evaluate the risk of mortality associated with hypercalcaemia.
A retrospective study was performed in all inpatients with elevated blood calcium levels admitted from July 2013 to June 2018. ICD coding data identified primary diagnoses and mortality. Electronic medical records were reviewed in n = 292 patients admitted across 12 months from January to December 2017, to determine the causes of hypercalcaemia.
Hypercalcaemia occurred in 1819 admissions (0.93% of all hospital admissions), during the 5-year period. The admission primary diagnoses were: malignancy (20% of cases), cardiovascular disease (17%) and gastrointestinal disease (11%). The top causes of hypercalcaemia among the 292 cases where electronic records were reviewed were malignancy (26%), primary hyperparathyroidism (25%) and hyperparathyroidism in the setting of chronic kidney disease (12%). Mortality occurred in 17% of these admissions. Non-survivors had significantly higher calcium levels, phosphate and white cell count, and had lower haemoglobin and albumin levels.
Hypercalcaemia occurred in ~1% of admissions with main causes being malignancy and primary hyperparathyroidism, similar to historical studies. Hypercalcaemia in hospitalised patients is associated with high mortality and higher levels may be a marker for more severe underlying disease.
研究住院患者高钙血症的文献大多发表于 20 多年前，而高钙血症的流行病学可能已经发生了变化，与寿命延长以及恶性肿瘤等潜在病因的患病率变化有关。
探讨澳大利亚一家现代三级医院住院患者高钙血症的流行病学，并评估高钙血症相关死亡率的风险。
本研究为回顾性研究，纳入 2013 年 7 月至 2018 年 6 月间血钙升高的所有住院患者。ICD 编码数据识别主要诊断和死亡率。对 2017 年 1 月至 12 月期间 12 个月内住院的 292 例患者的电子病历进行回顾性分析，以确定高钙血症的病因。
5 年间，1819 例住院患者（占所有住院患者的 0.93%）发生高钙血症。入院的主要诊断为：恶性肿瘤（20%）、心血管疾病（17%）和胃肠道疾病（11%）。292 例电子病历回顾患者中高钙血症的主要病因是恶性肿瘤（26%）、原发性甲状旁腺功能亢进症（25%）和慢性肾脏病伴甲状旁腺功能亢进症（12%）。这些住院患者中有 17%死亡。非幸存者的血钙、磷酸盐和白细胞计数明显更高，血红蛋白和白蛋白水平明显更低。
住院患者中高钙血症的发生率约为 1%，主要病因是恶性肿瘤和原发性甲状旁腺功能亢进症，与历史研究相似。住院患者高钙血症与高死亡率相关，血钙水平升高可能是潜在疾病更严重的标志物。
