Serum Calcium Concentration and its Association with Disease Severity in Critically Ill Patients Admitted to Intensive Care Unit.

Calcium is one of the most important electrolytes of human body and regulators of cell events, such as signaling, hormone secretion, glycogen metabolism, and cell mitosis. Extracellular calcium not only is a source for intracellular calcium but also has an important role in the maintenance and stability of cell wall and clot formation (1). The wide range in the concentration of total calcium may be related to changes in albumin concentration or any change in hydration in patients. Considering the important role of calcium in the human body, the high prevalence of hypocalcaemia in ICU patients, and the low number of studies assessing the correlation between serum calcium with ICU outcomes, we decided to determine the relationship between total calcium concentrations and disease severity in critically ill patients (2). A total of 100 patients admitted to intensive care units of Esi Medical college, Bangalore during Jan 2021 and june 2022 were enrolled in this cross sectional study. Total calcium on the day of admission and their relationship with APACHE score and disease severity were noted during the study. A total of 100 patients were enrolled, among them 58% were males and 42% were females. The mean age of the study participants were 66.3 years. There was significant difference of mean Arterial pH score, Apache Score, Serum Mg+ and serum Ca+ between the patients with GCS Score <8 (comatose) and patients with GCS = 8 (Non-Comatose). There was significant correlation (r = -0.599) between the Apache Score and GCS score. Also, Apache score was related to the Serum Mg+ (-0.422) and Serum Ca+ (-0.541). There was a medium and a statistically significant inverse relationship between disease severity and total calcium and magnesium concentration (P < 0.001). A significant correlation was found between total calcium and disease severity. Hypocalcemia is a predictor of disease severity and mortality. We recommend measuring ionized calcium concentration for patients admitted to ICU. References Calvi LM, Bushinsky DA. When is it appropriate to order an ionized calcium? J Am Soc Nephrol. 2008;19(7):1257-1256 Sanaie S, Mahmoodpoor A, Hamishehkar H, et al. Association between disease severity and calcium concentration in critically ill patients admitted to intensive care unit. Anesth Pain Med. 2018;8(1):e57583. Kelly A, Levine MA. Hypocalcemia in the critically ill patient. J Intensive Care Med 2013;28(3):166-77.

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© Journal of the Association of Physicians of India 2011.