PDF(Pubmed)
Abstract：
BACKGROUND: In major trauma patients, hypocalcemia is associated with increased mortality. Despite the absence of strong evidence on causality, early calcium supplementation has been recommended. This study investigates whether calcium supplementation during trauma resuscitation provides a survival benefit.
METHODS: We conducted a retrospective analysis using data from the TraumaRegister DGU® (2015-2019), applying propensity score matching to balance demographics, injury severity, and management between major trauma patients with and without calcium supplementation. 6 h mortality, 24 h mortality, and in-hospital mortality were considered as primary outcome parameters.
RESULTS: Within a cohort of 28,323 directly admitted adult major trauma patients at a European trauma center, 1593 (5.6%) received calcium supplementation. Using multivariable logistic regression to generate propensity scores, two comparable groups of 1447 patients could be matched. No significant difference in early mortality (6 h and 24 h) was observed, while in-hospital mortality appeared higher in those with calcium supplementation (28.3% vs. 24.5%, P = 0.020), although this was not significant when adjusted for predicted mortality (P = 0.244).
CONCLUSIONS: In this matched cohort, no evidence was found for or against a survival benefit from calcium supplementation during trauma resuscitation. Further research should focus on understanding the dynamics and kinetics of ionized calcium levels in major trauma patients and identify if specific conditions or subgroups could benefit from calcium supplementation.
METHODS: We conducted a retrospective analysis using data from the TraumaRegister DGU® (2015-2019), applying propensity score matching to balance demographics, injury severity, and management between major trauma patients with and without calcium supplementation. 6 h mortality, 24 h mortality, and in-hospital mortality were considered as primary outcome parameters.
RESULTS: Within a cohort of 28,323 directly admitted adult major trauma patients at a European trauma center, 1593 (5.6%) received calcium supplementation. Using multivariable logistic regression to generate propensity scores, two comparable groups of 1447 patients could be matched. No significant difference in early mortality (6 h and 24 h) was observed, while in-hospital mortality appeared higher in those with calcium supplementation (28.3% vs. 24.5%, P = 0.020), although this was not significant when adjusted for predicted mortality (P = 0.244).
CONCLUSIONS: In this matched cohort, no evidence was found for or against a survival benefit from calcium supplementation during trauma resuscitation. Further research should focus on understanding the dynamics and kinetics of ionized calcium levels in major trauma patients and identify if specific conditions or subgroups could benefit from calcium supplementation.
摘要：
背景：在严重创伤患者中，低钙血症与死亡率增加相关.尽管缺乏关于因果关系的有力证据，建议早期补充钙。这项研究调查了在创伤复苏期间补充钙是否可以提供生存益处。
方法：我们使用来自TraumaRegisterDGU®（2015-2019）的数据进行了回顾性分析，应用倾向得分匹配来平衡人口统计，损伤严重程度,以及补充和不补充钙的严重创伤患者之间的管理。6小时死亡率，24小时死亡率，院内死亡率被认为是主要结局参数.
结果：在欧洲创伤中心的28,323名直接入院的成年严重创伤患者中，1593（5.6％）接受了钙补充。使用多变量逻辑回归生成倾向评分，1447例患者的两个相当组可以匹配.早期死亡率(6小时和24小时)没有观察到显著差异，而补充钙的患者的住院死亡率更高(28.3%vs.24.5%,P=0.020),尽管在校正预测死亡率时这并不显著(P=0.244).
结论：在这个匹配的队列中，没有发现证据支持或反对创伤复苏期间补充钙的生存获益.进一步的研究应集中在了解严重创伤患者中离子钙水平的动力学和动力学，并确定特定的条件或亚组是否可以从钙补充中受益。
方法：我们使用来自TraumaRegisterDGU®（2015-2019）的数据进行了回顾性分析，应用倾向得分匹配来平衡人口统计，损伤严重程度,以及补充和不补充钙的严重创伤患者之间的管理。6小时死亡率，24小时死亡率，院内死亡率被认为是主要结局参数.
结果：在欧洲创伤中心的28,323名直接入院的成年严重创伤患者中，1593（5.6％）接受了钙补充。使用多变量逻辑回归生成倾向评分，1447例患者的两个相当组可以匹配.早期死亡率(6小时和24小时)没有观察到显著差异，而补充钙的患者的住院死亡率更高(28.3%vs.24.5%,P=0.020),尽管在校正预测死亡率时这并不显著(P=0.244).
结论：在这个匹配的队列中，没有发现证据支持或反对创伤复苏期间补充钙的生存获益.进一步的研究应集中在了解严重创伤患者中离子钙水平的动力学和动力学，并确定特定的条件或亚组是否可以从钙补充中受益。
