title: Long-term follow-up of patients with elevated serum calcium concentrations in Swedish primary care.
abstract: OBJECTIVE
  To follow up patients with elevated calcium concentrations after 10 years.
  
  
  METHODS
  Longitudinal, using medical records, questionnaires, and clinical investigation.
  
  
  METHODS
  Primary care in Tibro, Sweden, 2008-2010.
  
  
  METHODS
  127 patents with elevated calcium concentrations and 254 patients with normal calcium concentrations from the local community, attending the health care centre.
  
  
  METHODS
  Diagnoses and mortality in patients with elevated calcium concentrations in 1995-2000, compared with patients with normal calcium concentrations and the background population.
  
  
  RESULTS
  The proportion of patients for whom no underlying cause was detected decreased from 55% at baseline to 12% at follow-up. Primary hyperparathyroidism was most common in women, 23% at baseline and 36% at follow-up, and the cancer prevalence increased from 5% to 12% in patients with elevated calcium concentration. Mortality tended to be higher in men with elevated calcium concentrations compared with men with normal calcium concentrations, and was significantly higher than in the background population (SMR 2.3, 95% CI 1.3-3.8). Cancer mortality was significantly increased in men (p = 0.039). Low calcium concentrations were also associated with higher mortality (p = 0.004), compared with patients with normal calcium concentrations.
  
  
  CONCLUSIONS
  This study underscores the importance of investigating patients with increased calcium concentrations suggesting that most of these patients--88% in our study--will turn out to have an underlying disease associated with hypercalcaemia during a 10-year follow-up period. Elevated calcium concentrations had a different disease pattern in men and women, with men showing increased cancer mortality in this study.
authors.affiliation: Institute of Medicine, Department of Public Health and Community, Primary Health Care, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.
authors.forename: Sofia
authors.initials: S
authors.lastname: Dalemo
authors.forename: Robert
authors.initials: R
authors.lastname: Eggertsen
authors.forename: Per
authors.initials: P
authors.lastname: Hjerpe
authors.forename: Svante
authors.initials: S
authors.lastname: Jansson
authors.forename: Erik G
authors.initials: EG
authors.lastname: Almqvist
authors.forename: Kristina
authors.initials: K
authors.lastname: Bengtsson Boström
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D049950:Hyperparathyroidism, Primary / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D002118:Calcium