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Acta Medica Colombiana

Print version ISSN 0120-2448

Abstract

ROJAS-GARZON, LILIA ANDREA et al. Malignant hypercalcemia at a national referral center. A retrospective analysis. Acta Med Colomb [online]. 2022, vol.47, n.4, pp.27-32.  Epub May 27, 2023. ISSN 0120-2448.  https://doi.org/10.36104/amc.2022.2555.

Malignant hypercalcemia is the most frequent endocrinological emergency in cancer. The factors related to its occurrence have not been evaluated, nor are there any related studies in Colombia.

Objective:

to determine the factors associated with the onset of malignant hypercalcemia (MH) in patients hospitalized at Instituto Nacional de Cancerología (2014-2019).

Design:

a retrospective analytical case-control study

Population:

230 cases of adults with cancer and calcium corrected for albumin equal to or greater than 10.5 mg/dL and 223 controls of cancer patients with normal corrected calcium (8.5 to 10.4 mg/ dL) were included. Squamous cell carcinoma was used as the pairing variable.

Analysis:

univariate and bivariate analyses between the variables and the occurrence of MH were conducted to determine association, and raw ORs were calculated. Depending on their statis tical significance (p<0.05), they were included in the logistic regression for multivariate analysis and to rule out bias.

Results:

the median calcium for cases: 12.98 mg/dL (11.64-14.42) vs. 9.4 mg/dL (9.02-9.74) (p < 0.0001). The two groups were similar in age and sex. There was more metastasis in the cases (60.0% vs. 39.91%) (p< 0.0001). Altogether, 54.34% of the cases developed neurological symp toms. The median hospital stay was 16 days (IQR 9-27) vs. 9 days (IQR 6-17) for the controls (p< 0.0001), and inpatient deaths occurred in 48.70% vs. 16.59% (p < 0.0001). The following showed an association with MH: normal albumin, OR 0.41 (95% CI 0.29-0.55); a Karnofsky Index greater than or equal to 70, OR 0.98 (95% CI 0.97-0.99); and metastasis, OR 1.87 (95% CI 1.23-2.84). (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2555).

Keywords : hypercalcemia; cancer; endocrinology; calcium; emergency.

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