Hypocalcemia in a Saudi intensive care unit

OBJECTIVE: Hypocalcemia has been a common abnormality in the West, seen in patients admitted to the intensive care unit (ICU). It has also been linked with disease severity. We undertook this study to determine the frequency of hypocalcemia in patients admitted to the intensive care unit. MATERIALS AND METHODS: In a retrospective chart review from January 2004 till December 2004, patients admitted to our ICU were reviewed. Patients’ age, sex, diagnosis, acute physiology and chronic health score APACHE II and ionized calcium were recorded. Patients were divided into three groups based on disease severity as measured by APACHE II. Hypocalcemia was defined as ionized Ca level less than 1.18 mmol/L. Frequency was determined in each group and correlation of hypocalcemia with disease severity was explored. RESULTS: Hypocalcemia was seen in 22.2% in group A (APACHE II < 10), 40.4% in group B (APACHE II 10–19) and 53.9% in group C (APACHE II > 19). Hypocalcemia and disease severity (APACHE II scores) were negatively correlated (P = 0.02). Mean ionized Ca levels in groups A, B and C were 1.22 mmol/L (±0.10), 1.19 mmol/L (±0.11) and 1.25 mmol/L (±0.24) respectively. CONCLUSIONS: Hypocalcemia is a common finding in critically ill patients. It is correlated with worsening disease severity. Mechanisms underlying hypocalcemia and the possible relationship of hypocalcemia with mortality need further consideration.