Serum calcium phosphate product as a predictor of mortality in hospitalized patients.

Thesis Report.

ABSTRACT:

Background and aim: Recent studies have shown that elevated calcium phosphate arithmetic product (CaP) can lead to
extraosseous calcifications and increase the risk of death. The aim of this study was to compare
the admission CaP between survivors and non survivors and investigate if that could predict the
survival outcomes in critically ill non-CKD patients.

Methods: Altogether 126 study participants were enrolled which comprised of 3 cohorts: 52 critically ill non
CKD patients, 49 CKD patients and 25 healthy subjects. Blood samples were collected within 24
hours of admission and calcium, phosphate, and CaP were estimated. Statistical analysis was
performed on SPSS version 25.

Results: The admission levels of phosphate, and CaP were significantly higher in non-survivors (p= 0.002
and 0.011). Regression analysis revealed that phosphate (r2=0.170, p= 0.002) and CaP (r2=0.122,
p= 0.011) could significantly predict mortality. ROC analysis showed satisfactory performance of
admission phosphate and CaP (AUC= 0.719 and 0.621) in classifying patients at risk of mortality.
Kaplan-Meier survival analysis showed the lowest survival rates in admission CaP < 22 mg2/dL2
and > 43 mg2/dL2.

Conclusion: Abnormal CaP is associated with increased incidence of mortality in critically ill patients and
measuring CaP at admission can be a useful tool to predict the survival outcomes.