Evidence mapPaperPMID 38467491Full record

Observational studyESC heart failure2024

U-shaped association between serum calcium and in-hospital mortality in patients with congestive heart failure.

Kai Zhang, Yu Han, Tianyi Cai, Fangming Gu, Zhaoxuan Gu, JiaYu Zhao, Jianguo Chen, Bowen Chen, Min Gao, Zhengyan Hou and 6 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Kai ZhangDepartment of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.ORCID https://orcid.org/0000-0002-4069-6319
Yu HanDepartment of Ophthalmology, The First Hospital of Jilin University, Changchun, China.
Tianyi CaiBethune Second College of Clinical Medicine, Jilin University, Changchun, China.
Fangming GuDepartment of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.
Zhaoxuan GuDepartment of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.
JiaYu ZhaoDepartment of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.
Jianguo ChenBethune First College of Clinical Medicine, Jilin University, Changchun, China.
Bowen ChenBethune First College of Clinical Medicine, Jilin University, Changchun, China.
Min GaoDepartment of Cancer Center, The First Hospital of Jilin University, Changchun, China.
Zhengyan HouBethune Second College of Clinical Medicine, Jilin University, Changchun, China.
Xiaoqi YuBethune Second College of Clinical Medicine, Jilin University, Changchun, China.
Yafang GaoBethune Second College of Clinical Medicine, Jilin University, Changchun, China.
Rui HuBethune Third College of Clinical Medicine, Jilin University, Changchun, China.
Jinyu XieDepartment of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.
Tianzhou LiuDepartment of Gastrointestinal Surgery, The Second Hospital of Jilin University, Changchun, China.
MaoXun HuangDepartment of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.

Funding

Science and Technology Development of Jilin Province YDZJ202101ZYTS005
6 · The paper itself

Abstract

aimsSerum calcium level is widely used for evaluating disease severity, but its impact on clinical outcomes in patients with congestive heart failure (CHF) remains poorly understood. The aim of this study is to investigate the relationship between serum calcium levels and in-hospital mortality in CHF patients. METHODS AND

resultsWe conducted a retrospective analysis utilizing clinical data from the Medical Information Mart for Intensive Care database, encompassing a cohort of 15 983 CHF patients. This cohort was stratified based on their serum calcium levels, with the primary objective being the determination of in-hospital mortality. To assess the impact of admission serum calcium levels on in-hospital mortality, we employed various statistical methodologies, including multivariable logistic regression models, a generalized additive model, a two-piecewise linear regression model, and subgroup analysis. Comparative analysis of the reference group (Q3) revealed increased in-hospital mortality in the first quintile (Q1, the group with the lowest blood calcium level) and the fifth quintile (Q5, the group with the highest blood calcium level), with fully adjusted odds ratios of 1.38 [95% confidence interval (CI): 1.13-1.68, P = 0.002] and 1.23 (95% CI: 1.01-1.5, P = 0.038), respectively. A U-shaped relationship was observed between serum calcium levels and in-hospital mortality, with the lowest risk occurring at a threshold of 8.35 mg/dL. The effect sizes and corresponding CIs below and above this threshold were 0.782 (95% CI: 0.667-0.915, P = 0.0023) and 1.147 (95% CI: 1.034-1.273, P = 0.0094), respectively. Stratified analyses confirmed the robustness of this correlation.

conclusionsOur study identifies a U-shaped association between serum calcium levels and in-hospital mortality in CHF patients, with a notable inflection point at 8.35 mg/dL. Further investigation through prospective, randomized, and controlled studies is warranted to validate the findings presented in this study.

Indexed as

CalciumHeart FailureHospital MortalityAgedBiomarkersFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk FactorsSurvival RateBiomarkersCalciumAssociationBlood calciumCongestive heart failureGeneralized additive modelIn‐hospital mortalitySubgroup analysis

Identifiers

PMID38467491
PMCPMC11424285

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.