ArticleFrontiers in medicine2025
Association between serum calcium levels and the risk of invasive mechanical ventilation in COPD: a retrospective cohort study.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Disturbances in serum calcium levels have been associated with poor prognosis in various diseases. However, research regarding the relationship between serum calcium and the risk of invasive mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD) remains limited. This study aims to investigate the association between serum calcium levels and the need for invasive mechanical ventilation in COPD patients. Methods: We utilized data from patients diagnosed with COPD in the MIMIC-IV database. The cohort was stratified into two groups: patients who required invasive mechanical ventilation in the intensive care unit (ICU) and those who did not. Various analytical methods, including univariate and multivariate logistic regression models, were employed to examine the association. Additionally, restricted cubic splines (RCS) were used to illustrate the relationship. Results: Our study included a total of 2876 COPD patients, with 1022 in the invasive mechanical ventilation (IMV) group and 1854 in the non-mechanical ventilation (non-MV) group. Serum calcium levels in the IMV group were significantly lower than those in the non-MV group. After adjusting for confounding variables, reduced serum calcium levels were associated with an increased risk of invasive mechanical ventilation in COPD patients (odds ratio [OR] = 1.33, 95% confidence interval [CI]: 1.05-1.68). The RCS plot demonstrated that when serum calcium levels fell below 8.45 mg/dL, the risk of invasive mechanical ventilation increased with declining calcium concentrations. In subgroup analysis, COPD patients with cerebrovascular disease showed an elevated risk of requiring invasive mechanical ventilation. Conclusion: Chronic obstructive pulmonary disease patients requiring invasive mechanical ventilation exhibit significantly lower serum calcium levels compared to those not undergoing mechanical ventilation. Hypocalcemia is associated with an increased risk of invasive mechanical ventilation in COPD patients, particularly among individuals with concomitant cerebrovascular diseases.
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