Calcium administration appears not to benefit acute pancreatitis patients with hypocalcemia

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2023-12-06 DOI:10.1002/jhbp.1397

Tianao Yan, Yifei Ma, Zheng Wang, Jun Lyu, Shuai Wu, Chun Zhang, Wanzhen Wei, Jiahui Zeng, Zhenhua Ma, Kedong Xu

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引用次数: 0

Abstract

Objective

Hypocalcemia occurs commonly among patients with acute pancreatitis (AP) in the intensive care unit (ICU). Calcium therapy could be used to correct hypocalcemia and maintain calcium levels, but its impact on the prognosis has not been demonstrated. Our study aimed to determine whether calcium therapy could benefit the multiple outcomes of AP patients with hypocalcemia.

Methods

We extracted 807 AP patients with hypocalcemia from the Beth Israel Deaconess Medical Center (MIMIC-IV) database and performed retrospective analyses. The outcomes were in-hospital, 28 days, ICU mortality, and the length of stay (LOS) in the hospital and ICU. We performed propensity matching (PSM) and inverse probability weighting (IPTW) to balance the baseline differences and conducted multivariate regression to investigate the impact of calcium therapy.

Results

A total of 620 patients (76.8%) received calcium treatment (calcium group) during hospitalization, while 187 patients (non-calcium group) did not. Patients in the calcium group did not present significant survival differences between groups before and after matching. After including covariates, calcium administration had no association with patients' in-hospital (HR: 1.03, 95% Cl: 0.47–2.27, p = .942), 28 days and ICU mortality and was significantly associated with prolonged length of stay in the hospital (effect estimate: 6.18, 95% Cl: 3.27–9.09, p < .001) and ICU (effect estimate: 1.72, 95% Cl: 0.24–3.20, p < .001). Calcium therapy could not benefit patients in subgroups with exclusive parenteral infusion, early calcium therapy (<48 h), or various degrees of hypocalcemia.

Conclusion

AP patients with hypocalcemia could not benefit from calcium administration, which has no association with multiple mortality and is significantly associated with prolonged LOS in the hospital and ICU.

Abstract Image

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钙给药似乎对急性胰腺炎低钙患者无效。

目的:低钙血症常见于重症监护病房(ICU)的急性胰腺炎(AP)患者。钙治疗可用于纠正低钙血症和维持钙水平，但其对预后的影响尚未得到证实。我们的研究旨在确定钙治疗是否有利于低钙血症AP患者的多种预后。方法:我们从贝斯以色列女执事医疗中心(MIMIC-IV)数据库中提取807例AP低钙患者，并进行回顾性分析。结果为住院天数、28天、ICU死亡率、住院时间(LOS)。我们采用倾向匹配(PSM)和逆概率加权(IPTW)来平衡基线差异，并进行多变量回归来研究钙治疗的影响。结果:住院期间钙组620例(76.8%)接受钙治疗，非钙组187例(76.8%)未接受钙治疗。补钙组患者配型前后生存率无明显差异。纳入协变量后，钙给药与患者住院时间(HR: 1.03, 95% Cl: 0.47-2.27, p = 0.942)、28天及ICU死亡率无相关性，与住院时间延长有显著相关性(效应估计:6.18,95% Cl: 3.27-9.09, p)。低钙AP患者不能从补钙中获益，这与多重死亡率无关，但与医院和ICU的长期LOS显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.