Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, China.
Department of Laboratory Medicine, Shaanxi Provincial People's Hospital, Xi'an, 710068, China.
Sci Rep. 2024 Aug 12;14(1):18683. doi: 10.1038/s41598-024-69885-4.
This study investigates serum calcium's prognostic value in pediatric pneumonia, focusing on its correlation with PICU mortality, to enhance understanding and treatment approaches in this field. Data from 414 pediatric pneumonia patients (2010-2019) admitted to the intensive care units at the Children's Hospital, Zhejiang University School of Medicine were analyzed. The study utilized restricted cubic spline analysis, Cox proportional hazard regression, and Kaplan-Meier survival curve analysis to assess the relationship between serum calcium levels at admission and PICU mortality risk. After adjusting for multivariate factors, for each 1 mmol/dL increase in serum calcium, the risk of mortality decreased by 24% (HR: 0.76, 95% CI 0.67-0.87). Among the three levels of serum calcium groups, higher serum calcium levels were linked to a 63% reduction in the mortality rate compared to lower levels (HR: 0.37, 95% CI 0.16-0.84). The cumulative hazard estimates of mortality significantly differed across serum calcium groups (log-rank P = 0.032). This association was consistent across diverse subgroups (P for interaction > 0.05). Higher serum calcium levels are associated with decreased PICU mortality in pediatric pneumonia, highlighting its potential as a prognostic marker.
本研究旨在探讨血清钙在小儿肺炎中的预后价值，特别是其与 PICUMORTALITY 的相关性，以增强对此领域的认识并提供更好的治疗方法。该研究分析了浙江大学医学院附属儿童医院重症监护病房收治的 414 例小儿肺炎患者（2010-2019 年）的数据。研究采用限制性立方样条分析、Cox 比例风险回归和 Kaplan-Meier 生存曲线分析来评估入院时血清钙水平与 PICUMORTALITY 风险之间的关系。在校正了多变量因素后，血清钙每增加 1mmol/dL，死亡率的风险降低 24%（HR：0.76，95%CI0.67-0.87）。在血清钙三组中，较高的血清钙水平与死亡率降低 63%相关（HR：0.37，95%CI0.16-0.84）。死亡率的累积风险估计在血清钙组之间有显著差异（对数秩检验 P=0.032）。这种关联在不同的亚组中是一致的（交互作用的 P>0.05）。较高的血清钙水平与小儿肺炎 PICUMORTALITY 降低相关，提示其可能作为预后标志物。
