The Prognostic Significance Of Hypocalcemia In The Elderly Patients With Multiple Organ Dysfunction Syndrome

ObjectiveTo observe the serum calcium level in MODSE, and to investigate the prognostic significance of hypocalcemia in MODSE patients.Methods70 MODES patients were enrolled after they had been hospitalized in emergency center or emergency observer room of Tianjin medical university general hospital from January 2005 to October 2006. Blood samples were obtained within 24 hours of admission. Serum ionized calcium level was estimated by a published method. We also counted APACHEâ…¡score and evaluated organ function. Patients were divided into two groups, survivors and non-survivors. Statistical significance was calculated using the t-test for continuous variables and the chi-squared test for discrete variables. The one-way analysis of variance (ANOVA), correlations and the Fisher's exact test were also used where appropriate. Based upon the results, we performed the multinomial logistic regression analysis and found risk factors, established logistic regression equation and counted the sensitivity and specificity using ROC curve. At last, comparisons between serum ionized calcium level and the numbers of failure organ were made using Wilcoxon ranks sum test. Results@@@@APACHEâ…¡score, Serum ionized calcium and PTH level are risk factors for prognosis of MODSE. The sensitivity is 57.1%, 74.3% and 65.7%, respectively. The specificity is 82.9%, 62.9% and 51.6%, respectively. We find negative correlation between serum ionized calcium level and APACHEâ…¡score(P<0.05), but no correlation between ionized calcium level and serum PTH(P>0.05). There is statistics meaning between serum ionized calcium level and the numbers of failure organ (P<0.05).@@@@Conclusions@@@@Ionized hypocalcemia is a very common abnormality in MODSE patients and it has been shown to correlate with increased mortality. Negative correlation between serum ionized calcium level and APACHEâ…¡score, but no correlation between ionized serum calcium level and serum PTH. The lower serum ionized calcium, the more numbers of organ failure. Gaving intravenous calcium drugs, we can raise the level of serum ionized calcium, but can not improve the prognosis of MODSE patients with moderate to severe hypocalcemia. Serum ionized calcium level is easy to obtain in the hospitals and should be the regular monitoring index for MODSE patients.