The correlation between the hypoalbuminaemia and hypocalcaemia in sepsis patients: A retrospective study from MIMIC-III

Weijia Li, Lei Huang, Hua Luo, Weixing Zhang, Wencheng He*

Department of Intensive Care Unit, Peking University Shenzhen Hospital, No,1120, Lianhua Road, Futian District, Shenzhen, 518000, China

Objective: Hypoalbuminemia and hypocalcaemia are two common abnormalities in sepsis, little is known about their possible correlation during the sepsis process. We investigated the correlation between hypoalbuminemia and hypocalcaemia and their combinatorial effects on the prognosis in sepsis. 

Methods: Eligible septic patients were extracted from the MIMIC-III database. Cox-regression analysis was performed to examine the potential risk of hypoalbuminemia combined with hypocalcaemia on the mortality in the septic patients. The possible correlation between the serum albumin and calcium was examined by Pearson correlation analysis, and the various effects of different doses of albumin supplementation on the serum calcium level and prognosis were also examined.

Result: There were more than 60% of septic patients who had hypoalbuminemia hypocalcaemia during the ICU admission, In the marked hypoalbuminemia groups, patients with normal calcium level displayed the highest risk on mortality (OR: 7.714, 95% CI 3.292-18.075; p<0.001), while patients with marked hypocalcaemia have a relatively lowest risk on mortality (OR: 7.714, 95% CI 3.292-18.075; p<0.001). Cross-sectional analysis further showed that either total calcium (r=-0.950, p=0.004) or iron calcium (r=-0.904, p= 0.013) was found to be negatively correlated with the albumin during the ICU stay, and non-survivors had lower albumin and total calcium level in comparison with the survivors. The higher dose of albumin supplementation might down regulate the total calcium level and displayed lower mortality. 

Conclusion: Hypoalbuminemia and hypocalcaemia exhibited negative correlation in septic patients during their ICU stay. Hypocalcaemia might be protective in the septic patients who with marked hypoalbuminemia.