目的:分析住院患者高钙血症的研究有限。我们的目标是描述高钙血症住院患者的临床特征,估计其在医院环境中的患病率,分析高钙血症的纠正率,并确定预后变量。
方法:观察性,纵向,回顾性,和双中心研究。纳入了马拉加两家医院(2014-2018年)诊断为高钙血症的成年患者。最低随访时间为2年或直至死亡。
结果:共纳入205例高钙血症患者(发生率:0.13%)。平均年龄(SD)为68.2(13.1)岁,以男性为主(55.1%)。入院时血清钙中位数(IQR)为13.1(11.8-14.6)mg/dl。最常见的病因是肿瘤(75.1%),原发性甲状旁腺功能亢进,和药物(均为8.8%)。中位(IQR)随访期为5.1(1.7-60.3)周。最常用的治疗方法是液体疗法(86.8%),loop利尿剂(70.9%),双膦酸盐(60.7%),和糖皮质激素(46.2%)。高钙血症的纠正率为65.2%,中位数(IQR)为6(3-10)天。死亡率为81.5%。中位生存期(95%CI)为5.1(3-7.3)周。与较高死亡率相关的因素是高龄,肿瘤病因学,入院时血清钙,未能纠正高钙血症。
结论:住院患者的高钙血症主要是由于肿瘤形成过程,并与高死亡率相关。我们观察到对高钙血症治疗建议的依从性较低。
There are limited studies analyzing hypercalcemia in hospitalized patients. Our objectives were to describe the clinical characteristics of hospitalized patients with hypercalcemia, estimate its prevalence in the hospital setting, analyze the rate of correction of hypercalcemia, and identify prognostic variables.
Observational, longitudinal, retrospective, and bicentric
study. Adult patients admitted to two hospitals in Málaga (2014-2018) with a diagnosis of hypercalcemia were included. The minimum follow-up was 2 years or until death.
A total of 205 patients with hypercalcemia were included (incidence: 0.13%). The mean age (SD) was 68.2 (13.1) years, with a predominance of males (55.1%). The median (IQR) serum calcium at admission was 13.1 (11.8-14.6) mg/dl. The most common etiologies were neoplasms (75.1%), primary hyperparathyroidism, and medications (both 8.8%). The median (IQR) follow-up period was 5.1 (1.7-60.3) weeks. The most commonly used treatments were fluid therapy (86.8%), loop diuretics (70.9%), bisphosphonates (60.7%), and glucocorticoids (46.2%). The rate of correction of hypercalcemia was 65.2%, with a median (IQR) of 6 (3-10) days. The mortality rate was 81.5%. The median (95% CI) survival was 5.1 (3-7.3) weeks. Factors associated with higher mortality were advanced age, neoplastic etiology, serum calcium at admission, and failure to correct hypercalcemia.
Hypercalcemia in hospitalized patients is mainly due to neoplastic processes and is associated with high mortality. We observed a low rate of adherence to recommendations for the management of hypercalcemia.