Meng Kaiwu, Lei Xiaoyang, He Dian
Neurology Department, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
Neurology Department, The People's Hospital of QianNan, Duyun, Guizhou, China.
Front Neurol. 2024 Oct 18;15:1428868. doi: 10.3389/fneur.2024.1428868. eCollection 2024.
The relationship between serum calcium levels and the prognosis of cerebral infarction remains controversial.
This study aims to investigate the correlation between serum calcium levels and in-hospital mortality in critically ill patients with ischemic stroke admitted to the intensive care unit (ICU).
A retrospective cohort study was conducted using data from the MIMIC-IV database. Demographic and clinical data of all participants were collected including gender, age, hypertension, diabetes, myocardial infarction, heart failure, chronic obstructive pulmonary disease, hemoglobin, potassium, sodium, anion gap, platelets, white blood cells, glucose, creatinine, Glasgow coma score (GCS), IV-tPA administration (rt-PA), and mechanical thrombectomy (MT). The outcome measure was in-hospital death. Multivariable-adjusted logistic regression analysis, curve fitting, interaction analysis, and threshold effect analysis were employed to evaluate the relationship between serum calcium levels and in-hospital mortality among ICU patients with cerebral infarction.
A total of 2,680 critically ill patients with cerebral infarction were enrolled, with a mean serum calcium level of 8.6 ± 0.8 mg/dL. The overall in-hospital mortality rate was 19.5%, where Group 1 (serum calcium < 8.0 mg/dL) had a mortality rate of 27.7%, Group 2 (serum calcium 8-9 mg/dL) had a rate of 19.8%, and Group 3 (serum calcium ≥ 9 mg/dL) had a rate of 13.9%. There was a non-linear, S-shaped relationship between serum calcium levels and in-hospital mortality. Serum calcium levels within the range of 7.70-9.50 mg/dL were found to be independently associated with increased in-hospital mortality in ICU patients with cerebral infarction. No significant interactions were detected in subgroup analyses, and the results of sensitivity analyses remained stable.
Serum calcium levels are independently associated with in-hospital mortality in critically ill patients with cerebral infarction in the ICU setting. Within the range of 7.70-9.50 mg/dL, lower serum calcium levels increase the risk of in-hospital death among these patients, emphasizing the importance of close monitoring by ICU physicians.
血清钙水平与脑梗死预后之间的关系仍存在争议。
本研究旨在探讨重症监护病房（ICU）收治的缺血性卒中重症患者血清钙水平与院内死亡率之间的相关性。
使用MIMIC-IV数据库的数据进行回顾性队列研究。收集所有参与者的人口统计学和临床数据，包括性别、年龄、高血压、糖尿病、心肌梗死、心力衰竭、慢性阻塞性肺疾病、血红蛋白、钾、钠、阴离子间隙、血小板、白细胞、血糖、肌酐、格拉斯哥昏迷评分（GCS）、静脉注射组织型纤溶酶原激活剂（IV-tPA，rt-PA）和机械取栓术（MT）。结局指标为院内死亡。采用多变量调整逻辑回归分析、曲线拟合、交互作用分析和阈值效应分析来评估ICU脑梗死患者血清钙水平与院内死亡率之间的关系。
共纳入2680例重症脑梗死患者，血清钙平均水平为8.6±0.8mg/dL。总体院内死亡率为19.5%，其中第1组（血清钙<8.0mg/dL）死亡率为27.7%，第2组（血清钙8 - 9mg/dL）死亡率为19.8%，第3组（血清钙≥9mg/dL）死亡率为13.9%。血清钙水平与院内死亡率之间存在非线性S形关系。发现血清钙水平在7.70 - 9.50mg/dL范围内与ICU脑梗死患者院内死亡率增加独立相关。亚组分析未检测到显著的交互作用，敏感性分析结果保持稳定。
在ICU环境下，血清钙水平与重症脑梗死患者的院内死亡率独立相关。在7.70 - 9.50mg/dL范围内，较低的血清钙水平会增加这些患者的院内死亡风险，强调了ICU医生密切监测的重要性。
