Prevalence and outcomes of hypocalcemia on ED arrival in traumatic patients before blood transfusions: a systematic review and meta-analysis

Srichuachom, Wuttipong; Krintratun, Sarunsorn; Chenthanakij, Boriboon; Wongtanasarasin, Wachira

doi:10.1186/s13049-025-01361-y

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Table 1 Details of included studies and summary of patient characteristics

From: Prevalence and outcomes of hypocalcemia on ED arrival in traumatic patients before blood transfusions: a systematic review and meta-analysis

No	Study Country	Study type	Study duration	Setting	Cohort size (n)	Patients with hCa (n)	Patients with shCa (n)	Definitions of hCa and shCa	Age– years, mean ± SD	Male (%)	Blunt injury (%)	ISS, median (IQR)		Mortality (%)
No	Study Country	Study type	Study duration	Setting	Cohort size (n)	Patients with hCa (n)	Patients with shCa (n)	Definitions of hCa and shCa	Age– years, mean ± SD	Male (%)	Blunt injury (%)	hCa	Normal Ca	hCa	Normal Ca
1	Vivien, 2005 France	Prospective observational cohort	2002	Level 1 academic trauma center	212	156	21	hCa: iCa < 1.15 mmol/L shCa: iCa < 0.9 mmol/L	37 ± 16	74	98	34 (29–36)^a 59 (41–75)^b	16 (12–24)	19^a, 71^b	5
2	Cherry, 2006 USA	Retrospective observational cohort	2000–2002	Level 1 trauma center	396	91	N/A	iCa < 1 mmol/L	37 ± 5	N/A	N/A	25 (13–34)	22 (13–34)	26	16
3	Choi, 2008 Korea	Ambispective observational cohort	2005	University hospital	255	248	53	hCa: iCa < 1.15 mmol/L shCa: iCa < 0.88 mmol/L	47 ± 16	77	95	N/A	N/A	11^a, 30^b	14
4	Magnotti, 2011 USA	Prospective observational cohort	2008	Level 1 trauma center	591	332	N/A	iCa < 1 mmol/L	38^c	78	78	23	18	16	9
5	Webster, 2016 UK	Retrospective observational cohort	2013–2014	Trauma audit research network	55	30	N/A	iCa < 1.1 mmol/L	33^c	65	82	N/A	N/A	N/A	N/A
6	Vasudeva, 2019 Australia	Retrospective observational cohort	2014–2018	Level 1 trauma center	226	113	6	hCa: iCa < 1.1 mmol/L shCa: iCa < 0.8 mmol/L	44 ± 21	66	86	38 (24–43)	26 (17–34)	26	15
7	Byerly, 2020 USA	Retrospective observational cohort	2004	Level 1 trauma center	7,341	N/A	716	shCa: iCa < 0.9 mmol/L	39 (26–55)^c	81	51	25 (14–34)^b	14 (9–22)	38^b	10
8	Helshoot, 2023 Multi-center	Retrospective observational cohort	2015–2019	Trauma registry DGU	30,183	3,982	240	hCa: iCa < 1.1 mmol/L shCa: iCa < 0.9 mmol/L	54 (35–70)^c	71	93	22 (16–29)	20 (14–29)	21^a, 36^b	14
9	Scahid Jr, 2023 USA	Prospective observational cohort	N/A	Urban level 1 trauma center	68	16	N/A	iCa < 1 mmol/L	37 ± 18	81	81	22 (15–34)	13 (8–24)	12	8
10	Badarni, 2023 Israel	Retrospective observational cohort	2014–2020	Level 1 trauma center	201	147	13	hCa: iCa < 1.16 mmol/L shCa: iCa < 1 mmol/L	53 (28–69)^c	82	95	29 (25–30)	26 (25–29)	20	19
11	Maekkodathil, 2023 Qatar	Retrospective observational cohort	2016–2021	Level 1 trauma center	922	757	N/A	Ca < 2.2 mmol/L	32 ± 15	94	N/A	23 ± 11^d	28 ± 10^d	24	12
12	Vettorello, 2023 Italy	Retrospective observational cohort	2015–2021	Level 1 trauma center	798	129	N/A	iCa < 1.11 mmol/L	47 ± 20	74	100	38 (28–50)	26 (20–33)	13	3
13	Ahmed, 2024 Egypt	Prospective observational cohort	2022	Level 1 trauma center	60	30	N/A	iCa < 1.11 mmol/L	46 ± 18	87	100	N/A	N/A	73	30
14	Ciaraglia, 2024 USA	Retrospective observational cohort	2016–2019	Trauma registry	1,981	869	N/A	iCa < 1 mmol/L	40 (27–58)^c	73	73	N/A	N/A	16	11
15	Liaud-Laval, 2024 France	Retrospective observational cohort	2015–2021	Level 1 trauma center	137	134	23	hCa: iCa < 1.2 mmol/L shCa: iCa < 0.9 mmol/L	39 (23–55)^c	76	75	26 (17–34)^a 34 (27–40)^b	26 (19–34)	39^b	N/A

All numbers in the table have been rounded
^a for patients with mild hypocalcemia, ^b for patients with severe hypocalcemia, ^c reported as median (IQR, if available), ^d reported as mean ± SD
Abbreviations: hCa, hypocalcemia; iCa, ionized calcium; N/A, not applicable; shCa, severe hypocalcemia

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