The effect of ionized calcium levels on prognosis in trauma patients

Objective: The aim of this study was to investigate the relationship between ionized calcium (iCa) levels on admission and mortality in trauma patients hospitalized in the intensive care unit (ICU). Materials and Methods: Between 01.01.2021 and 31.12.2022, a total of 92 patients aged ≥18 years who were followed up for more than 24 hours due to trauma in the Anesthesiology and Reanimation ICU of our hospital were included in the study. Demographic and clinical characteristics, laboratory data, Glasgow coma scale (GCS) and Injury Severity Score (ISS) scores, mechanical ventilator needs and mortality of trauma patients were compared according to ionized iCa levels. Patients were divided into two groups as hypocalcemic patients with iCa<1.00 mmol/L and normocalcemic patients with iCa≥1.00 mmol/L according to iCa levels in the first blood gas obtained in the emergency department. Results: When we divided the groups according to iCa levels, there was no significant difference between the groups in terms of age, gender and chronic diseases. The median duration of hospitalization was 7 days and there was no difference between the groups (p=0.417). 60.9% of the patients were admitted to the intensive care unit due to traffic accidents, 22.8% due to falls and 16.3% due to gunshot wounds. 50% of the patients needed surgery, 63% needed mechanical ventilation and 32.6% needed inotropes. There was no significant difference in GCS (p=0.720) and ISS (p=0.263) scoring in both groups. 73.9% of the patients were mortal and there was no significant difference in mortality between the two groups (p=0.434). When survival was analyzed between the groups, 30-day survival was 29.2% in the group with iCa<1.00 mmol/L and 34.4% in the group with iCa≥1.00 mmol/L (logrank p= 0.043). Conclusion: Although there was no difference in mortality between the groups in our study, 30-day survival of hypocalcemic patients with iCa<1.00mmol/L was found to be lower. Larger prospective studies investigating the relationship between early blood gas iCa levels and mortality in trauma patients can be performed. Keywords: Calcium, Intensive Care, Mortality, Trauma.