Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Disorders of calcium metabolism in hospitalised inpatients: Determining the prevalence and characteristics  (#522)

Karen E Bromley 1 , Samantha Rankin 2 , Adeline Morton 3 , Melissa Gillett 4 , Emma J Hamilton 5 6
  1. Medical Education Unit, Fiona Stanley Hospital, Murdoch, WA, Australia
  2. Clinical Excellence Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  3. Data and Analytics Services, Pathwest, Murdoch, Western Australia, Australia
  4. Biochemistry Department, Pathwest, Murdoch, Western Australia, Australia
  5. Endocrinology Department, Fiona Stanley Hospital, Murdoch, WA, Australia
  6. Medical School, University of Western Australia, Nedlands, Western Australia, Australia

Limited data are available on the frequency of calcium metabolism disorders in hospitalised patients within the Australian context. We aimed to determine the prevalence of hypocalcaemia and hypercalcaemia for inpatients admitted to Fiona Stanley Hospital (FSH) during 2023 and describe associated characteristics.

Laboratory records were analysed for all patients admitted to FSH between 1st January and December 31st 2023, who had either hypocalcaemia (total plasma calcium adjusted for albumin <2.1mmol/L) or hypercalcaemia (total plasma calcium adjusted for albumin >2.6mmol/L) during their admission. Characteristics extracted included ward, admission and discharge date, age, gender and other biochemistry.  This was compared to hospital data for overnight (duration ≥1 day) and day (duration <1 day) admissions over the same time period.

3.6% (n=1106) of overnight admissions were complicated by hypocalcaemia and 2.8% (n=863) by hypercalcaemia. For overnight admissions complicated by hypocalcaemia, median length of stay was 9 days (interquartile range 5-17). Calcium level had a strong negative correlation with length of stay (r=-0.12, p=0.00002). 89 admissions had 25-hydroxyvitamin D measured, of which 43.8% (n=39) had Vitamin D deficiency (25-hydroxyvitamin D <50nanomol/L). 35% of admissions were to the intensive care unit (n=389).

Overnight admissions complicated by hypercalcaemia had a median length of stay of 9 days (interquartile range 4-19). There was no correlation between calcium level and length of stay. 195 admissions had parathyroid hormone recorded, of which 72.8% (n=142) were likely parathyroid dependent (parathyroid hormone >1.6nanomol/L). Hypocalcaemia (0.898%) and hypercalcaemia (0.289%) was infrequent amongst day admissions, occurring predominantly in haemodialysis and day therapy units.

Disorders of calcium metabolism were found to be common amongst hospital inpatients in an Australian tertiary hospital, and there was a strong correlation between hypocalcaemia severity and length of stay.  As such, it is important that health services have robust processes for the identification and management of these conditions.

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