Table 2.
Interventions of trauma patients with severe hypocalcemia compared to no severe hypocalcemia from January 2004 to December 2014 (n = 7341)
| Variable | Total, n = 7341 | Severe hypocalcemia, n = 716 | No severe hypocalcemia, n = 6625 | P value |
|---|---|---|---|---|
| Intubated, n (%) | 2211 (30.3) | 337 (47.1) | 1874 (28.4) | <0.0001 |
| Intravenous fluids, median (IQR) | 1000 (860–2000) | 1000 (1000–2000) | 1000 (800–2000) | 0.0420 |
| Next Phase After ED, n (%) | 7341 | 716 | 6625 | <0.0001 |
| ICU | 2899 (39.5) | 160 (22.3) | 2739 (41.3) | |
| OR | 2432 (33.1) | 514 (71.8) | 1918 (29.0) | |
| Ward | 1799 (24.5) | 34 (4.7) | 1765 (26.6) | |
| Stepdown | 107 (1.5) | 2 (0.3) | 105 (1.6) | |
| Unknown | 89 (1.2) | 4 (0.6) | 85 (1.3) | |
| Other | 15 (0.2) | 2 (0.3) | 13 (0.2) | |
| pRBC, unit, median (IQR) | ||||
| Prior to min iCa | 0 (0–2) | 8 (4–15) | 0 (0–2) | <0.0001 |
| Total, first 24 h | 0 (0–3) | 11 (6–21) | 0 (0–2) | <0.0001 |
| Total, length of stay | 1 (0–4) | 14 (8–25) | 0 (0–4) | <0.0001 |
| FFP, unit, median (IQR) | ||||
| Prior to min iCa | 0 (0–0) | 4 (2–8) | 0 (0–0) | <0.0001 |
| Total, first 24 h | 0 (0–2) | 8 (4–14) | 0 (0–0) | <0.0001 |
| Total, length of stay | 0 (0–2) | 9 (4–18) | 0 (0–2) | <0.0001 |
| Platelet, unit, median (IQR) | ||||
| Prior to min iCa | 0 (0–0) | 0 (0–2) | 0 (0–0) | <0.0001 |
| Total, first 24 h | 0 (0–0) | 1 (0–3) | 0 (0–0) | <0.0001 |
| Total, length of stay | 0 (0–0) | 2 (0–4) | 0 (0–2) | <0.0001 |
| Cryoprecipitate, unit, median (IQR) | ||||
| Prior to min iCa | 0 (0–0) | 0 (0–0) | 0 (0–0) | <0.0001 |
| Total, first 24 h | 0 (0–0) | 0 (0–0) | 0 (0–0) | <0.0001 |
| Total, length of stay | 0 (0–0) | 0 (0–0) | 0 (0–0) | <0.0001 |
| Transfusion given in first 24 h, n (%) | 2849 (38.8) | 678 (94.7) | 2178 (32.9) | <0.0001 |
| Factor VII given in first 24 h, n (%) | 153 (2.1) | 104 (14.5) | 49 (0.7) | <0.0001 |
| Massive transfusion patient, n (%) | 667 (9.1) | 425 (59.4) | 242 (3.7) | <0.0001 |
| First iCa, median (IQR) | 4 (3.9–4.6) | 4 (3.4–4.4) | 4.4 (4.0–4.7) | <0.0001 |
| Minimum iCa first 48 h, median (IQR) | 4.4 (4.0–4.6) | 3.1 (2.5–3.4) | 4.4 (4.1–4.7) | <0.0001 |
| Maximum iCa in first 48 h, median (IQR) | 4.8 (4.6–5.0) | 4.8 (4.5–5.1) | 4.8 (4.6–4.9) | 0.3760 |
| Last iCa in first 48 h, median (IQR) | 4.7 (4.4–4.8) | 4.5 (4.0–4.8) | 4.7 (4.5–4.8) | <0.0001 |
| Time to min iCa, minutes, median (IQR) | 338.0 (149–955.5) | 185.0 (108–339) | 408.5 (169–1114) | |
| Time to max iCa, minutes, median (IQR) | 706.0 (224–1743.5) | 453.0 (154.–1293) | 776.5 (249–1815.5) | <0.0001 |
| Intervention in 48 h, n (%) | 7341 | 716 | 6625 | <0.0001 |
| None | 5117 (69.7) | 298 (41.6) | 4819 (72.7) | |
| OR | 2195 (29.9) | 408 (57.0) | 1787 (27.0) | |
| IR | 16 (0.2) | 2 (0.3) | 14 (0.2) | |
| Both | 13 (0.2) | 8 (1.1) | 5 (0.1) |
Severe hypocalcemia defined as ionized calcium less than 0.9 mmol/dL or 3.6 mg/dL within 48 h of admission
Massive transfusion defined as 10 unit pRBC or more in 24 h
ED Emergency Department, ICU intensive care unit, OR operating room, pPRBC packed red blood cells, min minimum, iCa ionized calcium, FFP fresh frozen plasma, max maximum, IR interventional radiology