The Prognostic Value of Calcium in Post-Cardiovascular Surgery Patients in the Intensive Care Unit

Siwei Bi; Ruiqi Liu; Jingyi Li; Shanshan Chen; Jun Gu

doi:10.3389/fcvm.2021.733528

The Prognostic Value of Calcium in Post-Cardiovascular Surgery Patients in the Intensive Care Unit

Front Cardiovasc Med. 2021 Oct 5:8:733528. doi: 10.3389/fcvm.2021.733528. eCollection 2021.

Authors

Siwei Bi¹, Ruiqi Liu², Jingyi Li¹, Shanshan Chen¹, Jun Gu³

Affiliations

¹ West China School of Medicine, Sichuan University, Chengdu, China.
² Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China.

Abstract

Background: Present researches exploring the prognostic value of calcium concentration are undermined by sample size and study design. Our study investigated the association of both total calcium (tCa) and ionized Ca (iCa) to short- and long-term mortality and other outcomes in post-cardiovascular surgery (PCS) patients admitted to intensive care unit (ICU) from two large public data sets. Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU) were inspected to identify PCS patients. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between calcium concentration and outcomes. The propensity score estimation was performed to validate our findings. Results: A total of 6122 and 914 patients were included from the MIMIC III and eICU data sets, respectively. The groups with the most patients were the mild hypo-iCa and hypo-tCa groups. The mild hypo-iCa group showed significant association with worse short-term and long-term prognosis, less use of ventilation, longer ICU and hospital stay, and more incidence of 7-day acute kidney injury. Conclusions: The mild hypo-iCa (0.9-1.15 mmol/L) within the first day of admission to the ICU could serve as an independent prognosis factor for PCS patients.

Keywords: calcium; cardiovascular surgery; intensive care unit; kidney injury; prognosis.