Yao Xiongda, Leng Yurong, Cao Junda
Department of Cardiology, Jiangxi Medical College, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China.
Department of Stomatology, Jiangxi Medical College, The Affiliated Stomatological Hospital, Nanchang University, Nanchang, Jiangxi, China.
Front Cardiovasc Med. 2025 Mar 6;12:1552807. doi: 10.3389/fcvm.2025.1552807. eCollection 2025.
Heart failure (HF), a global health challenge, is a leading cause of mortality in hospitalized patients. Early and accurate prognostic evaluation in these patients is vital for guiding clinical management. Our aim was to explore the association between albumin-corrected calcium (ACC) and mortality in hospitalized patients.
This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were stratified into three groups based on ACC levels. The association between ACC and clinical outcomes in HF patients was analyzed using Cox proportional hazards regression and restricted cubic spline models.
A total of 4,737 heart failure patients were included. Multifactorial Cox regression revealed that elevated ACC levels were significantly associated with increased 30-day and 180-day mortality. Restricted cubic spline analysis demonstrated a U-shaped relationship between ACC levels and mortality, with an inflection point at 9.18. Patients with ACC levels above 9.18 exhibited an 20.4% higher risk of 30-day mortality [Hazard ratio (HR): 1.204, 95% (Confidence interval) CI: 1.009-1.437] and a 20.8% higher risk of 180-day mortality (HR: 1.208, 95% CI: 1.019-1.431) compared to those with ACC below 9.18.
The observed U-shaped association between ACC levels and 30- and 180-day mortality in HF patients highlights the potential utility of ACC as a prognostic marker.
心力衰竭（HF）是一项全球性的健康挑战，是住院患者死亡的主要原因。对这些患者进行早期准确的预后评估对于指导临床管理至关重要。我们的目的是探讨白蛋白校正钙（ACC）与住院患者死亡率之间的关联。
这项回顾性队列研究使用了重症监护医学信息数据库IV（MIMIC-IV）中的数据。根据ACC水平将患者分为三组。使用Cox比例风险回归和受限立方样条模型分析HF患者中ACC与临床结局之间的关联。
共纳入4737例心力衰竭患者。多因素Cox回归显示，ACC水平升高与30天和180天死亡率增加显著相关。受限立方样条分析表明ACC水平与死亡率之间呈U形关系，拐点为9.18。与ACC水平低于9.18的患者相比，ACC水平高于9.18的患者30天死亡率风险高20.4%[风险比（HR）：1.204，95%置信区间（CI）：1.009-1.437]，180天死亡率风险高20.8%（HR：1.208，95%CI：1.019-1.431）。
HF患者中观察到的ACC水平与30天和180天死亡率之间的U形关联突出了ACC作为预后标志物的潜在效用。
