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Abstract: FR-PO311

Calcium-Phosphate Product and Its Impact on Mortality in Hospitalized Patients

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical

Authors

  • Mao, Michael A., Mayo Clinic, Rochester, Minnesota, United States
  • Thongprayoon, Charat, Bassett Medical Center, Cooperstown, New York, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Erickson, Stephen B., Mayo Clinic, Rochester, Minnesota, United States
Background

Calcium-phosphate product (CaP) of >55 mg2/dL2 is associated with acute or subacute calcification of vascular, cardiac, and other soft tissues. However, the relationship between admission CaP and in-hospital mortality in all hospitalized patients is unclear.

Methods

All adult hospitalized patients who had both admission serum calcium and phosphate levels available between years 2009 and 2013 were enrolled. Admission CaP was categorized based on its distribution into six groups (<21, 21-<27, 27-<33, 33-<39, 39-<45 and ≥45 mg2/dL2). The odds ratio (OR) of in-hospital mortality by admission CaP, using the CaP category of 27-<33 mg2/dL2 as the reference group, was obtained by logistic regression analysis.

Results

14,772 patients were studied. The lowest incidence of in-hospital mortality was associated with an admission CaP within 27-<33 mg2/dL2. A U-shaped curve emerged demonstrating higher in-hospital mortality associated with both CaP <27 and ≥33 mg2/dL2. After adjusting for potential confounders, both CaP <21 and ≥39 mg2/dL2 were associated with an increased risk of in-hospital mortality with ORs of 1.60 (95% CI 1.07-2.37), 1.53 (95% CI 1.07-2.18) and 3.46 (95% CI 2.51-4.79) when CaP were within <21, 39-<45 and ≥45 mg2/dL2, respectively. Among a subgroup of patients with available serum albumin, the lowest incidence of in-hospital mortality was associated with corrected CaP within 33-<39 mg2/dL2. After adjusting for potential confounders, corrected CaP 39-<45 and ≥45 mg2/dL2 were associated with an increased risk of in-hospital mortality with ORs of 2.15 (95% CI 1.39-3.33) and 3.90 (95% CI 2.60-5.94) when CaP were within 39-<45and ≥45 mg2/dL2, respectively.

Conclusion

CaP levels on admission are associated with in-hospital mortality. Highest mortality risk is observed in hospitalized patients with admission CaP ≥45 mg2/dL2.