Abstract
Purposes
The aim of the study was to describe the prevalence, demographic, and clinical characteristics
and etiologies of hypercalcemia in emergency department patients.
Basic procedures
In this retrospective cross-sectional descriptive study, all patients admitted between
April 1, 2008, and March 31, 2011, to the emergency department of Inselspital, University
Hospital Bern, were screened for the presence of hypercalcemia, defined as a serum
calcium exceeding 2.55 mmol/L after correction for serum albumin. Demographic, laboratory,
and outcome data were gathered. A detailed medical record review was performed to
identify causes of hypercalcemia.
Main findings
During the study period, 14 984 patients (19% of all admitted patients) received a
measurement of serum calcium. Of these, 116 patients (0.7%) presented with hypercalcemia.
Median serum calcium was 2.72 mmol/L (first quartile, 2.64; third quartile, 2.88),
with 4.3 mmol/L being the maximum serum calcium value observed. Underlying malignancy
in 44% of patients and hyperparathyroidism in 20% (12% secondary and 8% primary) were
the leading causes of hypercalcemia. Twenty-six percent of patients presented with
symptomatic hypercalcemia. Weakness was the most common symptom of hypercalcemia,
followed by nausea and disorientation.
Principal conclusions
Hypercalcemia is a rare but harmful electrolyte disorder in emergency department patients.
Unspecific symptoms such as a change in mental state, weakness, or gastrointestinal
symptoms should prompt physicians to order serum calcium measurements, at least in
patients with known malignancy or renal insufficiency.
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Article Info
Publication History
Published online: December 13, 2012
Accepted:
November 6,
2012
Received in revised form:
November 6,
2012
Received:
October 17,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
