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Prognostic value of day-of-event serum calcium and magnesium for predicting 1-year prognosis after intracerebral hemorrhage

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Abstract

Aim

To investigate whether serum calcium and magnesium on the day of symptom onset contribute to prognosis at 1 year after intracerebral hemorrhage (ICH).

Methods

We prospectively enrolled patients admitted < 24 h after symptom onset of primary ICH to West China Hospital between January 2012 and October 2014. Blood samples were collected at admission to determine the concentration of serum calcium and magnesium. We analyzed associations of the serum concentration of calcium and magnesium with unfavorable outcome (defined as modified Rankin scale, mRS ≥ 3) at 1 year.

Results

We included 874 patients (mean age 59.1 ± 13.5 years, 67.6% males), of whom 470 patients had mRS ≥ 3 and 284 patients died at 1 year. Compared to patients with the highest tertile level of calcium concentration (≥ 2.29 mmol/L), patients in the lowest tertile (≤ 2.15 mmol/L) had higher odds of unfavorable outcome (odds ratio, OR 1.61, 95% confidence interval [CI] 1.04–2.50, P = 0.034). The Kaplan–Meier survival curve revealed a significant difference of cumulative survival rate across calcium tertiles (log-rank P value = 0.038). There was no significant association between serum concentration of magnesium and functional outcome at 1 year.

Conclusion

A reduced serum concentration of calcium on the day-of-event was associated with unfavorable outcome at 1 year after ICH. Future studies are needed to illustrate the pathophysiological mechanism of calcium and whether calcium could be a treatment target for improving outcomes after ICH.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (82171285; 81974181) and National Key Technology R&D Program of the 12th Five-Year Plan (2011BA108B05). The funding sources did not play any role in study design; collection, analysis or interpretation of data; writing of the manuscript; or decision to submit the manuscript for publication.

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Author notes

  1. Meng Liu and Yao Xiong contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Meng Liu, Xing Hua, Linrui Huang, Ming Liu & Simiao Wu

  2. The Affiliated Hospital of Southwest Jiaotong University &, The Third People’s Hospital of Chengdu, Chengdu, 610031, Sichuan, China

    Yao Xiong

  3. Department of Physiology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, China

    Weihong He

  4. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Chao You

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  1. Meng Liu
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Contributions

Meng Liu: Data curation (lead); formal analysis (equal); investigation (equal); methodology (equal); visualization (lead); writing-original draft (lead). Yao Xiong: Data curation (equal); formal analysis (equal); investigation (lead); methodology (equal); visualization (supporting); writing-original draft (equal). Xing Hua: Data curation (supporting); investigation (supporting); visualization (supporting); writing-review and editing (supporting). Linrui Huang: Data curation (supporting); investigation (supporting); writing-review and editing (supporting). Weihong He: Formal analysis (equal); writing-original draft (supporting); writing-review and editing (supporting). Chao You: Resources (lead); funding acquisition (equal); writing-review and editing (equal). Ming Liu: Resources (equal); funding acquisition (equal); supervision (equal); writing-review and editing (equal). Simiao Wu: Conceptualization (lead); formal analysis (lead); funding acquisition (lead); methodology (lead); supervision (lead); writing-review and editing (equal).

Corresponding author

Correspondence to Simiao Wu.

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Ethical approval

The study was approved by the Biomedical Research Ethics Committee of West China Hospital, Sichuan University [Reference No. 2013 (124)]. Participants provided informed consent before recruitment.

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The authors have stated explicitly that there are no conflicts of interest in connection with this article.

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Liu, M., Xiong, Y., Hua, X. et al. Prognostic value of day-of-event serum calcium and magnesium for predicting 1-year prognosis after intracerebral hemorrhage. Neurol Sci 44, 3957–3965 (2023). https://doi.org/10.1007/s10072-023-06886-7

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