Relationship of on Admission Hypocalcaemia and Illness Severity as Measured by APACHE-II and SOFA Score in Intensive Care Patients’
Introduction: Hypocalcaemia is very much prevalent in critically ill patients yet very less is known about its association with severity of illness. Acute Physiology and Chronic Health Evaluation (APACHE) and Sequential Organ Failure Assessment (SOFA) are two commonly used and validated scoring...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-03-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9402/22895_CE[Ra1]_F(DK)_PF1(PrG_RK)_PFA(DK)_PF2(NE_SY_DK).pdf |
| Summary: | Introduction: Hypocalcaemia is very much prevalent in
critically ill patients yet very less is known about its association
with severity of illness. Acute Physiology and Chronic Health
Evaluation (APACHE) and Sequential Organ Failure Assessment
(SOFA) are two commonly used and validated scoring tool used
to assess the severity of illness in critically ill patients.
Aim: To analyze the relation of on admission hypocalcaemia with
severity of illness as measured by APACHE-II and SOFA scores.
Materials and Methods: After institute approval, 111 patients
admitted during May to June 2016 were evaluated. Age, sex,
on admission, ionized calcium (iCa0) levels, first day APACHEII and SOFA scores were collected. Data were then divided in
different classes based on iCa0 levels (i.e., normocalcaemic,
mild, moderate and severe hypocalcaemic), APACHE-II and
SOFA scores and their relationship was assessed using INSTAT
software (GraphPad Software, Inc, La Zolla, CA, USA) with
appropriate statistical tests.
Results: Seventy eight (70.27%) patients were having hypocalcaemia on admission (<1.15 mmol/L). The mean APACHE-II score
of normocalcaemic patients were significantly (p<0.05) lower
as compared to moderate and severe hypocalcaemic patients
(15.57±6.85 versus 21.72±6.37 and 15.57±6.85 versus 22.34±7.53,
respectively). The mean iCa0 level in patients with APACHE-II
> 20 were significantly lower than patients with APACHE-II < 9
(0.88±0.26 versus 1.09±0.24, p <0.05) but the mean iCa0 level in
patients with SOFA > 9 were not significantly lower than patients with
SOFA < 4 (0.99±0.41 versus 1.04±0.23, p > 0.05). The relative risk
of on admission hypocalcaemia across increasing illness severity
was also not statistically significant. Both relative risk of mortality
and length of ICU stay were higher in on admission moderate
hypocalcaemic patients as compared to normocalcaemic but the
difference was not statistically significant.
Conclusion: On admission, hypocalcaemia has inconsistent
correlation with increasing illness severity in adult intensive care
patients. iCa0 of 0.81–0.90 mmol/L appears to have maximum
deleterious effect with regard to mortality and length of ICU stay. |
|---|---|
| ISSN: | 2249-782X 0973-709X |