Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : March | Volume : 11 | Issue : 3 | Page : UC01 - UC03

Relationship of on Admission Hypocalcaemia and Illness Severity as Measured by APACHE-II and SOFA Score in Intensive Care Patients’

Samarjit Dey, Habib Md Reazaul Karim, Mohd Yunus, Angkita Barman, Prithwis Bhattacharyya, Manas Pratim Borthakur

1. Assistant Professor, Department of Anaesthesiology, Critical Care and Pain Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 2. Assistant Professor, Department of Anaesthesiology, Critical Care and Pain Medicine, Andaman and Nicobar Island Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India. 3. Additional Professor, Department of Anaesthesiology, Critical Care and Pain Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 4. Senior Resident, Department of Anaesthesiology, Critical Care and Pain Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 5. Professor and Head, Department of Anaesthesiology, Critical Care and Pain Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 6. Postgraduate Student, Dep

Correspondence Address :
Dr. Habib Md Reazaul Karim,
Assistant Professor, Department of Anaesthesiology, Andaman and Nicobar Island Institute of Medical Sciences,
Port Blair-744104, Andaman and Nicobar, India.
E-mail: drhabibkarim@gmail.com

Abstract

Introduction: Hypocalcaemia is very much prevalent in critically ill patients yet very less is known about its association with severity of illness. Acute Physiology and Chronic Health Evaluation (APACHE) and Sequential Organ Failure Assessment (SOFA) are two commonly used and validated scoring tool used to assess the severity of illness in critically ill patients.

Aim: To analyze the relation of on admission hypocalcaemia with severity of illness as measured by APACHE-II and SOFA scores.

Materials and Methods: After institute approval, 111 patients admitted during May to June 2016 were evaluated. Age, sex, on admission ionized calcium (iCa0) levels, first day APACHEII and SOFA scores were collected. Data were then divided in different classes based on iCa0 levels (i.e., normocalcaemic, mild, moderate and severe hypocalcaemic), APACHE-II and SOFA scores and their relationship was assessed using INSTAT software (GraphPad Software, Inc, La Zolla, CA, USA) with appropriate statistical tests.

Results: Seventy eight (70.27%) patients were having hypocalcaemia on admission (<1.15 mmol/L). The mean APACHE-II score of normocalcaemic patients were significantly (p<0.05) lower as compared to moderate and severe hypocalcaemic patients (15.57±6.85 versus 21.72±6.37 and 15.57±6.85 versus 22.34±7.53, respectively). The mean iCa0 level in patients with APACHE-II > 20 were significantly lower than patients with APACHE-II < 9 (0.88±0.26 versus 1.09±0.24, p <0.05) but the mean iCa0 level in patients with SOFA > 9 were not significantly lower than patients with SOFA < 4 (0.99±0.41 versus 1.04±0.23, p > 0.05). The relative risk of on admission hypocalcaemia across increasing illness severity was also not statistically significant. Both relative risk of mortality and length of ICU stay were higher in on admission moderate hypocalcaemic patients as compared to normocalcaemic but the difference was not statistically significant.

Conclusion: On admission, hypocalcaemia has inconsistent correlation with increasing illness severity in adult intensive care patients. iCa0 of 0.81–0.90 mmol/L appears to have maximum deleterious effect with regard to mortality and length of ICU stay.

Keywords

Calcium, Critical illnesses, Critical care, Critical care outcome

How to cite this article :

Samarjit Dey, Habib Md Reazaul Karim, Mohd Yunus, Angkita Barman, Prithwis Bhattacharyya, Manas Pratim Borthakur. RELATIONSHIP OF ON ADMISSION HYPOCALCAEMIA AND ILLNESS SEVERITY AS MEASURED BY APACHE-II AND SOFA SCORE IN INTENSIVE CARE PATIENTS’. Journal of Clinical and Diagnostic Research [serial online] 2017 March [cited: 2017 Mar 29 ]; 11:UC01-UC03. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=March&volume=11&issue=3&page=UC01-UC03&id=9402

DOI and Others

DOI: 10.7860/JCDR/2017/22895.9402

Date of Submission: Jul 19, 2016
Date of Peer Review: Nov 01, 2016
Date of Acceptance: Nov 17, 2016
Date of Publishing: Mar 01, 2017

Date of Submission: Jul 19, 2016
Date of Peer Review: Nov 01, 2016
Date of Acceptance: Nov 17, 2016
Date of Publishing: Mar 01, 2017

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