Is severe hypocalcemia immediately life threatening?
Objective: Severe hypocalcemia (Ca <1.9 mmol/L) is often considered an emergency because of a potential risk of cardiac arrest or seizures. However, there is little evidence to support this. The aim of our study was to assess whether severe hypocalcemia was associated with immediately life-threat...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2018-10-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/7/10/EC-18-0267.xml |
| _version_ | 1811282479132180480 |
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| author | Maxime Duval Kalyane Bach-Ngohou Damien Masson Camille Guimard Philippe Le Conte David Trewick |
| author_facet | Maxime Duval Kalyane Bach-Ngohou Damien Masson Camille Guimard Philippe Le Conte David Trewick |
| author_sort | Maxime Duval |
| collection | DOAJ |
| description | Objective: Severe hypocalcemia (Ca <1.9 mmol/L) is often considered an emergency because of a potential risk of cardiac arrest or seizures. However, there is little evidence to support this. The aim of our study was to assess whether severe hypocalcemia was associated with immediately life-threatening cardiac arrhythmias or neurological complications.
Methods: A retrospective observational study was carried out over a 2-year period in the Adult Emergency Department (ED) of Nantes University Hospital. All patients who had a protein-corrected calcium concentration measure were eligible for inclusion. Patients with multiple myeloma were excluded. The primary outcome was the number of life-threatening cardiac arrhythmias and/or neurological complications during the stay in the ED.
Results: A total of 41,823 patients had protein-corrected calcium (pcCa) concentrations measured, 155 had severe hypocalcemia, 22 were excluded because of myeloma leaving 133 for analysis. Median pcCa concentration was 1.73 mmol/L (1.57–1.84). Seventeen (12.8%) patients presented a life-threatening condition, 14 (10.5%) neurological and 3 (2.2%) cardiac during ED stay. However, these complications could be explained by the presence of underlying co-morbidities and or electrolyte disturbances other than hypocalcemia. Overall, 24 (18%) patients died in hospital. Vitamin D deficiency, chronic kidney disease and hypoparathyroidism were the most frequently found causes of hypocalcemia.
Conclusion: Thirteen percent of patients with severe hypocalcemia presented a life-threatening cardiac or neurological complication on the ED. However, a perfectly valid alternative cause could account for these complications. Further research is warranted to define the precise role of hypocalcemia. |
| first_indexed | 2024-04-13T01:52:16Z |
| format | Article |
| id | doaj.art-dba469fe50a34678b31cbd11cf5f9aa2 |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-04-13T01:52:16Z |
| publishDate | 2018-10-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-dba469fe50a34678b31cbd11cf5f9aa22022-12-22T03:07:51ZengBioscientificaEndocrine Connections2049-36142049-36142018-10-01710https://doi.org/10.1530/EC-18-0267Is severe hypocalcemia immediately life threatening?Maxime Duval0Kalyane Bach-Ngohou1Damien Masson2Camille Guimard3Philippe Le Conte4David Trewick5Department of Medicine, Clinique Jules Verne, Nantes, FranceDepartment of Biology, Laboratory of Clinical Biochemistry, CHU Nantes, Nantes, FranceDepartment of Biology, Laboratory of Clinical Biochemistry, CHU Nantes, Nantes, FranceDepartment of Emergency Medicine, CHU Nantes, Nantes, FranceDepartment of Emergency Medicine, CHU Nantes, Nantes, FranceDepartment of Medicine, Clinique Jules Verne, Nantes, France; Department of Emergency Medicine, CHU Nantes, Nantes, FranceObjective: Severe hypocalcemia (Ca <1.9 mmol/L) is often considered an emergency because of a potential risk of cardiac arrest or seizures. However, there is little evidence to support this. The aim of our study was to assess whether severe hypocalcemia was associated with immediately life-threatening cardiac arrhythmias or neurological complications. Methods: A retrospective observational study was carried out over a 2-year period in the Adult Emergency Department (ED) of Nantes University Hospital. All patients who had a protein-corrected calcium concentration measure were eligible for inclusion. Patients with multiple myeloma were excluded. The primary outcome was the number of life-threatening cardiac arrhythmias and/or neurological complications during the stay in the ED. Results: A total of 41,823 patients had protein-corrected calcium (pcCa) concentrations measured, 155 had severe hypocalcemia, 22 were excluded because of myeloma leaving 133 for analysis. Median pcCa concentration was 1.73 mmol/L (1.57–1.84). Seventeen (12.8%) patients presented a life-threatening condition, 14 (10.5%) neurological and 3 (2.2%) cardiac during ED stay. However, these complications could be explained by the presence of underlying co-morbidities and or electrolyte disturbances other than hypocalcemia. Overall, 24 (18%) patients died in hospital. Vitamin D deficiency, chronic kidney disease and hypoparathyroidism were the most frequently found causes of hypocalcemia. Conclusion: Thirteen percent of patients with severe hypocalcemia presented a life-threatening cardiac or neurological complication on the ED. However, a perfectly valid alternative cause could account for these complications. Further research is warranted to define the precise role of hypocalcemia.https://ec.bioscientifica.com/view/journals/ec/7/10/EC-18-0267.xmlSevere hypocalcemiaemergency departmentseizureslife-threatening arrhythmias |
| spellingShingle | Maxime Duval Kalyane Bach-Ngohou Damien Masson Camille Guimard Philippe Le Conte David Trewick Is severe hypocalcemia immediately life threatening? Endocrine Connections Severe hypocalcemia emergency department seizures life-threatening arrhythmias |
| title | Is severe hypocalcemia immediately life threatening? |
| title_full | Is severe hypocalcemia immediately life threatening? |
| title_fullStr | Is severe hypocalcemia immediately life threatening? |
| title_full_unstemmed | Is severe hypocalcemia immediately life threatening? |
| title_short | Is severe hypocalcemia immediately life threatening? |
| title_sort | is severe hypocalcemia immediately life threatening |
| topic | Severe hypocalcemia emergency department seizures life-threatening arrhythmias |
| url | https://ec.bioscientifica.com/view/journals/ec/7/10/EC-18-0267.xml |
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