دورية أكاديمية
Discrepancies in corrected calcium versus ionised calcium in a geriatric population: an observational study.
| العنوان: | Discrepancies in corrected calcium versus ionised calcium in a geriatric population: an observational study. |
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| المؤلفون: | Suryapranata APSP; Department of Geriatric Medicine, Jeroen Bosch Hospital, s- Hertogenbosch, the Netherlands., Keijsers CJPW; Department of Geriatric Medicine, Jeroen Bosch Hospital, s- Hertogenbosch, the Netherlands., Kurstjens S; Laboratory of Clinical Chemistry and Hematology, Jeroen Bosch Hospital, s-Hertogenbosch, the Netherlands., Van Strien AM; Department of Geriatric Medicine, Jeroen Bosch Hospital, s- Hertogenbosch, the Netherlands. |
| المصدر: | Age and ageing [Age Ageing] 2024 Apr 01; Vol. 53 (4). |
| نوع المنشور: | Observational Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0375655 Publication Model: Print Cited Medium: Internet ISSN: 1468-2834 (Electronic) Linking ISSN: 00020729 NLM ISO Abbreviation: Age Ageing Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Oxford : Oxford University Press Original Publication: London, Baillière, Tindall. |
| مواضيع طبية MeSH: | Calcium* , Hypercalcemia*/diagnosis, Aged, 80 and over ; Humans ; Aged ; Albumins ; Hospitals |
| مستخلص: | Background: Calcium can be measured as ionised (Ca-ionised) or albumin-adjusted total calcium (Ca-albumin). Current clinical guidelines predominantly utilise Ca-albumin, despite Ca-ionised being the gold standard. Discrepancies can occur between these measurement modalities and can lead to clinical dilemmas. It remains unclear how large these discrepancies are in older patients. This study investigated the discrepancies between Ca-ionised and Ca-albumin in geriatric patients. Methods: This is an observational study of all geriatric patients (n = 876) in the Jeroen Bosch Hospital (January 2018 and January 2021) in whom both Ca-ionised and Ca-albumin were measured. Misclassification of calcaemic state (i.e. low, normal or high) was calculated (percentages), the measure of agreement was described using Cohen's Kappa and for the continuous data Pearson's correlation coefficient was used. Relevant categories of age and renal function were considered for effect modification effects and studied by interaction terms in a regression model. Results: In one-third of the measurements, there was a misclassification. Ca-albumin measurements failed to identify 28% of hypocalcaemia. In 3.5%, hypercalcemia based on Ca-albumin was not confirmed by Ca-ionised. The correlation coefficient between Ca-ionised and Ca-albumin was 0.743 (P = 0.01) and measure of agreement by Kappa was 0.213 (P < 0.001). In the oldest old (≥ 85 years) and patients with eGFR <30 ml/min/1.73 m2 ,the agreement by Kappa was lower, with values of 0.192 and 0.104, respectively. Conclusion: There is a discrepancy between Ca-albumin and Ca-ionised in one-third of the geriatric patients, leading to clinical dilemmas. In the oldest old and patients with renal dysfunction, this problem is most pronounced. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: albumin-adjusted calcium; calcium; ionised calcium; older patients; older people |
| المشرفين على المادة: | SY7Q814VUP (Calcium) 0 (Albumins) |
| تواريخ الأحداث: | Date Created: 20240412 Date Completed: 20240415 Latest Revision: 20240701 |
| رمز التحديث: | 20240701 |
| DOI: | 10.1093/ageing/afae072 |
| PMID: | 38610061 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1468-2834 |
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| DOI: | 10.1093/ageing/afae072 |