背景:很少有研究分析住院肿瘤患者高钙血症的特征。我们的目的是描述副肿瘤性高钙血症住院患者的临床特征,并确定死亡率的预后变量。
方法:这是一个观察性的,纵向,回顾性,和双中心研究。其中包括马拉加两家医院收治的成年患者,西班牙(2014-2018)。最短随访期为2年或直至死亡。
结果:共纳入154例患者;大多数(71.4%)进入内科。中位随访时间为3.5周(四分位距[IQR]1.1-11.5)。平均(标准差)年龄为67.6(12.3)岁,以男性为主(58.4%)。入院时血清钙中位数(IQR)为13.2(11.8-14.6)mg/dl。最常见的肿瘤是肺(27.3%),血液学(23.4%),泌尿外科(13%),和乳房(12.3%)。此外,56.5%的病例在诊断时具有已知的肿瘤病史。甲状旁腺激素(PTH)水平测定为24%;其中,10.8%的水平升高。总之,95.5%的患者在随访期间死亡。中位生存期为3.4周(95%置信区间2.6-4.3)。与较高死亡率相关的因素是年龄,入院时血清钙,以前的肿瘤病史,多发性骨髓瘤以外的病因,和未纠正高钙血症。
结论:在住院患者中,副肿瘤性高钙血症与高短期死亡率相关.在这些患者中发现了与预后较差相关的几个因素。
BACKGROUND: There are few studies that have analyzed the characteristics of hypercalcemia in hospitalized oncological patients. Our objectives were to describe the clinical characteristics of hospitalized patients with paraneoplastic hypercalcemia and to identify prognostic variables for mortality.
METHODS: This was an observational, longitudinal, retrospective, and bicentric study. It included adult patients admitted to two hospitals in Málaga, Spain (2014-2018). The minimum follow-up period was 2 years or until death.
RESULTS: A total of 154 patients were included; the majority (71.4%) were admitted to the internal medicine department. The median follow-up was 3.5 weeks (interquartile range [IQR] 1.1-11.5). The mean (standard deviation) age was 67.6 (12.3) years, with a predominance of males (58.4%). The median (IQR) serum calcium at admission was 13.2 (11.8-14.6) mg/dl. The most common neoplasms were pulmonary (27.3%), hematologic (23.4%), urological (13%), and breast (12.3%). Furthermore, 56.5% of cases had a known history of neoplasia at the time of diagnosis. The parathyroid hormone (PTH) level was determined in 24%; of these, 10.8% had elevated levels. In all, 95.5% of patients died during follow-up. The median survival was 3.4 weeks (95% confidence interval 2.6-4.3). Factors associated with higher mortality were age, serum calcium at admission, previous history of neoplasia, etiology other than multiple myeloma, and noncorrection of hypercalcemia.
CONCLUSIONS: In hospitalized patients, paraneoplastic hypercalcemia was associated with high short-term mortality. Several factors associated with a worse prognosis were identified in these patients.