Abstract：
OBJECTIVE: The prognostic role of baseline calcium levels in patients with intracerebral hemorrhage (ICH) is conflicting. We aimed to conduct the first meta-analysis in the literature to examine if baseline calcium levels can predict outcomes after ICH.
METHODS: English-language studies listed on the databases of Embase, PubMed, ScienceDirect, and Web of Science were searched up to 20th November 2023. Meta-analysis was conducted for baseline hematoma volume, hematoma expansion, unfavorable functional outcome, and mortality.
RESULTS: Ten studies were included. Meta-analysis showed that patients with hypocalcemia have significantly higher baseline hematoma volume (MD: 8.6 95 % CI: 3.30, 13.90 I2 = 88 %) but did not have a higher risk of hematoma expansion (OR: 1.82 95 % CI: 0.89, 3.73 I2 = 82 %). Meta-analysis of crude (OR: 1.86 95 % CI: 1.25, 2.78 I2 = 63 %) and adjusted data (OR: 2.05 95 % CI: 1.27, 3.28 I2 = 64 %) showed those with hypocalcemia had a significantly higher risk of unfavorable functional outcomes. Meta-analysis of both crude (OR: 2.09 95 % CI: 1.51, 2.88 I2 = 80 %) and adjusted data (OR: 1.38 95 % CI: 1.14, 1.69 I2 = 70 %) also demonstrated a significantly higher risk of mortality in patients with hypocalcemia.
CONCLUSIONS: Baseline serum calcium may have a prognostic role in ICH. Hypocalcemia at baseline may lead to large hematoma volume and poor functional and survival outcomes. However, there seems to be no relation between hypocalcemia and the risk of hematoma expansion. Further studies examining the role of calcium on ICH prognosis are needed.
METHODS: English-language studies listed on the databases of Embase, PubMed, ScienceDirect, and Web of Science were searched up to 20th November 2023. Meta-analysis was conducted for baseline hematoma volume, hematoma expansion, unfavorable functional outcome, and mortality.
RESULTS: Ten studies were included. Meta-analysis showed that patients with hypocalcemia have significantly higher baseline hematoma volume (MD: 8.6 95 % CI: 3.30, 13.90 I2 = 88 %) but did not have a higher risk of hematoma expansion (OR: 1.82 95 % CI: 0.89, 3.73 I2 = 82 %). Meta-analysis of crude (OR: 1.86 95 % CI: 1.25, 2.78 I2 = 63 %) and adjusted data (OR: 2.05 95 % CI: 1.27, 3.28 I2 = 64 %) showed those with hypocalcemia had a significantly higher risk of unfavorable functional outcomes. Meta-analysis of both crude (OR: 2.09 95 % CI: 1.51, 2.88 I2 = 80 %) and adjusted data (OR: 1.38 95 % CI: 1.14, 1.69 I2 = 70 %) also demonstrated a significantly higher risk of mortality in patients with hypocalcemia.
CONCLUSIONS: Baseline serum calcium may have a prognostic role in ICH. Hypocalcemia at baseline may lead to large hematoma volume and poor functional and survival outcomes. However, there seems to be no relation between hypocalcemia and the risk of hematoma expansion. Further studies examining the role of calcium on ICH prognosis are needed.
摘要：
目的：基线钙水平在脑出血（ICH）患者中的预后作用是相互矛盾的。我们旨在进行文献中的第一个荟萃分析，以检查基线钙水平是否可以预测ICH后的结局。
方法：在Embase数据库中列出的英语语言研究，PubMed,ScienceDirect,和WebofScience被搜索到2023年11月20日。对基线血肿体积进行Meta分析,血肿扩大,不利的功能结果，和死亡率。
结果：纳入10项研究。Meta分析显示，低钙血症患者的基线血肿体积明显增高（MD：8.695％CI：3.30，13.90I2=88％），但血肿扩大的风险不增高（OR：1.8295％CI：0.89，3.73I2=82％）。对粗数据(OR:1.8695%CI:1.25,2.78I2=63%)和校正数据(OR:2.0595%CI:1.27,3.28I2=64%)的荟萃分析显示，低钙血症患者出现不良功能结局的风险显著增高。对粗数据（OR：2.0995％CI：1.51，2.88I2=80％）和校正数据（OR：1.3895％CI：1.14，1.69I2=70％）的荟萃分析也表明，低钙血症患者的死亡风险明显更高。
结论：基线血清钙可能在ICH中具有预后作用。基线时的低钙血症可能导致大的血肿体积和不良的功能和生存结果。然而,低钙血症与血肿扩大的风险之间似乎没有关系。需要进一步研究钙在ICH预后中的作用。
方法：在Embase数据库中列出的英语语言研究，PubMed,ScienceDirect,和WebofScience被搜索到2023年11月20日。对基线血肿体积进行Meta分析,血肿扩大,不利的功能结果，和死亡率。
结果：纳入10项研究。Meta分析显示，低钙血症患者的基线血肿体积明显增高（MD：8.695％CI：3.30，13.90I2=88％），但血肿扩大的风险不增高（OR：1.8295％CI：0.89，3.73I2=82％）。对粗数据(OR:1.8695%CI:1.25,2.78I2=63%)和校正数据(OR:2.0595%CI:1.27,3.28I2=64%)的荟萃分析显示，低钙血症患者出现不良功能结局的风险显著增高。对粗数据（OR：2.0995％CI：1.51，2.88I2=80％）和校正数据（OR：1.3895％CI：1.14，1.69I2=70％）的荟萃分析也表明，低钙血症患者的死亡风险明显更高。
结论：基线血清钙可能在ICH中具有预后作用。基线时的低钙血症可能导致大的血肿体积和不良的功能和生存结果。然而,低钙血症与血肿扩大的风险之间似乎没有关系。需要进一步研究钙在ICH预后中的作用。
