Decreased serum calcium levels predict severe complications after initial diagnosis in patients with acute type B aortic dissection: A retrospective cohort study.

Abstract

This study sought to investigate the temporal variations in serum calcium concentrations among patients with acute type B aortic dissection (ATBAD) following initial diagnosis, document the incidence of severe complications, and evaluate their potential associations. In this retrospective analysis, we examined 42 consecutive patients diagnosed with ATBAD at Zhejiang Hospital between April 2019 and April 2024. Serum-ionized calcium levels were measured at admission and 24 hours post-admission. Based on changes in calcium levels, patients were categorized into either the elevated or decreased groups. Univariate and multivariate logistic regression analyses were performed to compare clinical characteristics and assess the incidence of severe complications following the initial diagnosis. The study further explored the association between 24-hour serum calcium levels, their dynamic changes, and the occurrence of severe complications in patients with ATBAD. The results showed that the decreased group had a significantly higher frequency of severe complications, including mortality, cardiac complications, acute renal failure, and organ hypoperfusion (P < 0.05), while no significant differences were observed for neurological or pulmonary complications (P > 0.05). Logistic regression revealed that a decline in serum calcium levels within 24 hours was an independent risk factor for severe complications (OR = 16.722, P = 0.03). The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.864. Decreased serum calcium concentration is an independent predictor of severe complications in ATBAD patients, significantly associated with mortality, cardiac complications, acute kidney injury, and inadequate organ perfusion. No significant correlation with neurological and pulmonary complications was observed.