Hypercalcemia in the emergency department.
BACKGROUND
Severe hypercalcemia can be life-threatening. However, its incidence and the underlying causes in the emergency department (ED) have not been determined. In the present study, we investigated these issues and the impacts on renal function and patients' survival.


METHODS
We performed a retrospective study to analyze the patients with hypercalcemia in the ED for 1 year. Serum total calcium level greater than 10.3 mg/dL was defined as hypercalcemia.


RESULTS
During the study period, 321 of 4293 patients (7.5%) were found to have hypercalcemia (serum calcium 11.7 +/- 1.6 mg/dL). Most of them had mild hypercalcemia (calcium level < 12.0 g/dL, 70.7%). Malignancy (36.4%) and uremia (32.4%) were the most common underlying causes. Normal renal function was observed in only 75 (23.4%) of all patients with hypercalcemia. The total mortality rate was 23.1%, and death was associated with male gender, higher calcium level, lower hemoglobin, and malignancy (all P < 0.05). Logistic analysis found that serum calcium and hemoglobin levels were independent risk factors for mortality.


CONCLUSIONS
Severe hypercalcemia is frequently and life-threatening in the ED. Therefore routine determination of serum calcium level is recommended, and immediate therapy should be initiated to treat the patients at high risk.
Lee
Chien-Te
CT
Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan.
Yang
Chih-Chao
CC
Lam
King-Kwan
KK
Kung
Chia-Te
CT
Tsai
Chia-Jung
CJ
Chen
Hung-Chun
HC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications / Q000209:etiology* / Q000401:mortality; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014511:Uremia / Q000150:complications
D002118:Calcium