Initial Calcium Derangements in Major Trauma and Outcomes
An erratum to this article was published (JAMA Netw Open, 1 Apr 2026 ↗)
Authors' conclusion
In this cohort study of trauma patients, hypercalcemia was less common than hypocalcemia; however, hypercalcemia was associated with worse mortality at all time points. Blood product consumption was higher among those with hypercalcemia or hypocalcemia compared with eucalcemia but was similar among those with any calcium derangement.
Study context
- Population
- Major trauma patients arriving within 24 h of injury with highest-level trauma activation, 3 US level I trauma centres, 2022–2024
- Participants
- 1,270 patients · 3 level I trauma centres
- Exposure
- Hypocalcaemia and hypercalcaemia vs eucalcaemia on emergency department (ED) arrival
- Hypocalcemicn = 282
- Eucalcemicn = 925reference
- Hypercalcemicn = 57
- Outcome
- Incidence of calcium derangements upon ED arrival
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Incidence of calcium derangements on ED arrival · ED arrival
Observational data: associations, not effects.
Further findings
Mortality · 24 hours
Administration of any blood product · first 24 hours
Median
| Outcome | Hypocalcemia | Eucalcemia | Hypercalcemia |
|---|---|---|---|
| Injury severity score | 21 (IQR 10–29) | 14 (IQR 5–25) | 22 (IQR 13–29) |
Mortality · 24 hours
- Mortality increased as derangements became more extreme, in a U-shaped relationship
Original publication
Initial Calcium Derangements in Major Trauma and Outcomes. JAMA Netw Open. Published 2 February 2026. doi:10.
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