title: Hypocalcaemia as a prognostic factor of early mortality in moderate and severe traumatic brain injury.
abstract: OBJECTIVE
  Our main objective was to evaluate whether serum hypocalcaemia on the third day [defined as < 2.1 mmol/l (8.5 mg/dl)] is a prognostic factor for early mortality after moderate and severe traumatic brain injury (TBI).
  
  
  METHODS
  We developed an ambispective comparative case control study. We evaluated clinical profiles from included patients from January 2005 to July 2009 and we prospectively recruited additional patients from August 2009 to July 2011. Patients were between 1 and 89 years old and had a Glasgow Coma Scale of 3-12 points following TBI.
  
  
  RESULTS
  We calculated an Odds Ratio of 5.2 (Confidence Intervals 95%: 4.48 to 6.032) for hypocalcaemia on day three, which was associated with death. Retrospectively (January 2005 to July 2009) we compiled data from 81 patients. Prospectively (August 2009 to July 2011) we recruited 41 patients. The adjusted variables in the logistic regression final model were: serum calcium on day three (Odds Ratio 3.5, Confidence Intervals 95%: 1·12 to 13·61, P < 0·028) and anisocoria (Odds Ratio 8·24, Confidence Intervals 95%: 1·3 to 67·35, P < 0·019) obtaining an adjusted R2 of 0·22 (P < 0·005).
  
  
  CONCLUSIONS
  The serum levels of calcium on day three could be useful for the prediction of mortality in patients with moderate and severe TBI.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Vinas-Rios
authors.forename: Martin
authors.initials: M
authors.lastname: Sanchez-Aguilar
authors.forename: Jose Juan
authors.initials: JJ
authors.lastname: Sanchez-Rodriguez
authors.forename: Daniel
authors.initials: D
authors.lastname: Gonzalez-Aguirre
authors.forename: Christian
authors.initials: C
authors.lastname: Heinen
authors.forename: Frerk
authors.initials: F
authors.lastname: Meyer
authors.forename: Thomas
authors.initials: T
authors.lastname: Kretschmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000175:diagnosis* / Q000401:mortality*; D002118:Calcium / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis*; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D002118:Calcium
keywords: Hypocalcaemia,; Predictive mortality factor,; Traumatic brain injury