Is hypercalcaemia immediately life-threatening? A prospective study
Objective: Hypercalcaemia is often considered as an emergency because of a potential risk of life-threatening arrhythmias or coma. However, there is little evidence, apart from case studies, that hypercalcaemia can be immediately life-threatening. The aim of our study was to prospectively assess whe...
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Bioscientifica
2025-01-01
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| Series: | Endocrine Connections |
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| Online Access: | https://ec.bioscientifica.com/view/journals/ec/14/2/EC-24-0508.xml |
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| author | David Trewick Mathilde Le Borgne Julie Regnault Camille Guimard |
| author_facet | David Trewick Mathilde Le Borgne Julie Regnault Camille Guimard |
| author_sort | David Trewick |
| collection | DOAJ |
| description | Objective: Hypercalcaemia is often considered as an emergency because of a potential risk of life-threatening arrhythmias or coma. However, there is little evidence, apart from case studies, that hypercalcaemia can be immediately life-threatening. The aim of our study was to prospectively assess whether hypercalcaemia (Ca ≥ 3 mmol/L) was associated with immediately life-threatening complications. Design and methods: We conducted a prospective observational study aiming to include the first one hundred patients aged ≥18 who had a calcium concentration ≥3 mmol/L, admitted to the emergency department (ED). The primary outcome was the number of life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation, sinus arrest and second- or third-degree atrioventricular blocks) or neurological complications defined by a Glasgow Coma Scale score <9 during the stay in the ED. The secondary outcomes were correlation between calcium concentrations and ECG (electrocardiogram) QTc intervals, Glasgow Coma Scale scores and mortality during the following 12-month follow-up period. Results: The median calcium concentration was 3.3 mmol/L (3.1–3.7). Cancer was the first cause of hypercalcaemia. No patient presented a life-threatening cardiac arrhythmia during their stay in the ED. Three patients presented a life-threatening neurological complication. There was no correlation between calcaemia and QTc intervals or Glasgow Coma Scale score. Prognosis was poor, and 43 patients died during the 12 months. Conclusions: We found no cases of immediately life-threatening cardiac arrhythmias. Three patients had indeed a life-threatening neurological complication but always had at least one other major factor that could severely alter mental status, such as profound metabolic acidosis. |
| format | Article |
| id | doaj-art-65754eaf380249a19d90f9e8d2c9b1db |
| institution | Kabale University |
| issn | 2049-3614 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj-art-65754eaf380249a19d90f9e8d2c9b1db2025-02-05T10:12:49ZengBioscientificaEndocrine Connections2049-36142025-01-0114210.1530/EC-24-05081Is hypercalcaemia immediately life-threatening? A prospective studyDavid Trewick0Mathilde Le Borgne1Julie Regnault2Camille Guimard3Department of Medicine, CHD Montaigu, Montaigu, FranceDepartment of Emergency Medicine, Nantes University, Nantes, FranceDepartment of Emergency Medicine, Nantes University, Nantes, FranceDepartment of Medicine, Clinique Jules Verne, Nantes, FranceObjective: Hypercalcaemia is often considered as an emergency because of a potential risk of life-threatening arrhythmias or coma. However, there is little evidence, apart from case studies, that hypercalcaemia can be immediately life-threatening. The aim of our study was to prospectively assess whether hypercalcaemia (Ca ≥ 3 mmol/L) was associated with immediately life-threatening complications. Design and methods: We conducted a prospective observational study aiming to include the first one hundred patients aged ≥18 who had a calcium concentration ≥3 mmol/L, admitted to the emergency department (ED). The primary outcome was the number of life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation, sinus arrest and second- or third-degree atrioventricular blocks) or neurological complications defined by a Glasgow Coma Scale score <9 during the stay in the ED. The secondary outcomes were correlation between calcium concentrations and ECG (electrocardiogram) QTc intervals, Glasgow Coma Scale scores and mortality during the following 12-month follow-up period. Results: The median calcium concentration was 3.3 mmol/L (3.1–3.7). Cancer was the first cause of hypercalcaemia. No patient presented a life-threatening cardiac arrhythmia during their stay in the ED. Three patients presented a life-threatening neurological complication. There was no correlation between calcaemia and QTc intervals or Glasgow Coma Scale score. Prognosis was poor, and 43 patients died during the 12 months. Conclusions: We found no cases of immediately life-threatening cardiac arrhythmias. Three patients had indeed a life-threatening neurological complication but always had at least one other major factor that could severely alter mental status, such as profound metabolic acidosis.https://ec.bioscientifica.com/view/journals/ec/14/2/EC-24-0508.xmlhypercalcaemiacomalife-threatening arrhythmiasqt interval |
| spellingShingle | David Trewick Mathilde Le Borgne Julie Regnault Camille Guimard Is hypercalcaemia immediately life-threatening? A prospective study Endocrine Connections hypercalcaemia coma life-threatening arrhythmias qt interval |
| title | Is hypercalcaemia immediately life-threatening? A prospective study |
| title_full | Is hypercalcaemia immediately life-threatening? A prospective study |
| title_fullStr | Is hypercalcaemia immediately life-threatening? A prospective study |
| title_full_unstemmed | Is hypercalcaemia immediately life-threatening? A prospective study |
| title_short | Is hypercalcaemia immediately life-threatening? A prospective study |
| title_sort | is hypercalcaemia immediately life threatening a prospective study |
| topic | hypercalcaemia coma life-threatening arrhythmias qt interval |
| url | https://ec.bioscientifica.com/view/journals/ec/14/2/EC-24-0508.xml |
| work_keys_str_mv | AT davidtrewick ishypercalcaemiaimmediatelylifethreateningaprospectivestudy AT mathildeleborgne ishypercalcaemiaimmediatelylifethreateningaprospectivestudy AT julieregnault ishypercalcaemiaimmediatelylifethreateningaprospectivestudy AT camilleguimard ishypercalcaemiaimmediatelylifethreateningaprospectivestudy |