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Serum Calcium Level is Associated with Mortality Risk in Patients with Sepsis-induced Coagulopathy

Li, Q.; Cheng, Y. D.

2025-07-05 intensive care and critical care medicine
10.1101/2025.07.03.25330792 medRxiv
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BackgroundElectrolyte disorders are prevalent in patients with sepsis-induced coagulopathy (SIC). The aim of this study was to explore the association between serum calcium levels and mortality in patients with SIC. MethodsWe screened the Medical Information Market for Intensive Care III database for the data of patients with SIC. Logistic regression analysis was performed to explore the risk factors for mortality in patients with SIC, and restricted cubic spline (RCS) was applied to fit the correlation between the serum calcium levels and SIC mortality. ResultsThe in-hospital mortality of patients with SIC was 32.2%. The mortality rate of patients in the first and third tertiles of serum calcium levels was higher than that of patients in the second tertile of serum calcium levels. Results of the univariate regression analysis revealed that serum calcium levels were not associated with mortality. The unadjusted RCS suggested a U-shaped relationship between serum calcium level and mortality. After adjusting for confounding factors, multivariate regression analysis revealed that the relationship between serum calcium level and mortality remained U-shaped. ConclusionThe incidence of mortality was high among patients with SIC who had abnormally low or high serum calcium levels. Physicians should pay attention to the clinical management of patients with SIC, especially hypercalcemia.

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