The effect of serum calcium level on the morbidity and mortality of patients with gastrointestinal bleeding

Introduction: The aim of this study was to investigate the relation of serum calcium, corrected calcium and ionized calcium levels with morbidity and mortality in patients followed-up with the diagnosis of gastrointestinal system bleeding. Methods: Patients over 18 years of age who had presented to the emergency clinics with a suspicion of gastrointestinal bleeding and followed-up at the intensive care units between January 2009 and December 2011 were included in this retrospective study. The demographic properties, biochemical and haematological parameters of the patients, the amount of blood transfusions, the durations of hospital stay and the outcomes were recorded. The patients were divided into two groups, as those who survived (Survival group) and those who died (Exitus group). They were also divided into three groups according to their ionized calcium levels. The differences between the groups were investigated. The relations of the variables with each other were also evaluated in the overall patient group. Findings: A total of 191 patients were included in the study, 126 of whom were male (66.0%) with a mean age of 63.8±19.0 years. The mean hemoglobin level was 9.4±2.8 g/dL, the mean calcium level was 8.2±0.7 mg/dL, the mean corrected calcium level was 8.9±0.6 mg/dL, and the mean ionized calcium level was 0.88±0.25 mmol/L. No significant differences were observed in the calcium, corrected calcium and ionized calcium levels between the group that had survived and the group which had died (p>0.05). A positive correlation was observed between the hemoglobin levels and the calcium levels (r=0.45, p<0.001), corrected calcium levels (r=0.37, p<0.001) and the ionized calcium levels (r=0.33, p=0.002). Conclusion: No correlation was observed between the calcium, corrected calcium and ionized calcium levels and the erythrocyte transfusion requirement, duration of hospital stay and mortality in patients with GIS bleeding. However, a weak correlation was observed between the calcium, corrected calcium and ionized calcium levels and the hemoglobin levels.