In major trauma patients, hypocalcemia is associated with increased mortality. Despite the absence of strong evidence on causality, early calcium supplementation has been recommended. This study investigates whether calcium supplementation during trauma resuscitation provides a survival benefit. We conducted a retrospective analysis using data from the TraumaRegister DGU® (2015–2019), applying propensity score matching to balance demographics, injury severity, and management between major trauma patients with and without calcium supplementation. 6 h mortality, 24 h mortality, and in-hospital mortality were considered as primary outcome parameters. Within a cohort of 28,323 directly admitted adult major trauma patients at a European trauma center, 1593 (5.6%) received calcium supplementation. Using multivariable logistic regression to generate propensity scores, two comparable groups of 1447 patients could be matched. No significant difference in early mortality (6 h and 24 h) was observed, while in-hospital mortality appeared higher in those with calcium supplementation (28.3% vs. 24.5%, P = 0.020), although this was not significant when adjusted for predicted mortality (P = 0.244). In this matched cohort, no evidence was found for or against a survival benefit from calcium supplementation during trauma resuscitation. Further research should focus on understanding the dynamics and kinetics of ionized calcium levels in major trauma patients and identify if specific conditions or subgroups could benefit from calcium supplementation.

中文翻译：

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创伤复苏期间补钙：来自 TraumaRegister DGU® 的倾向评分匹配分析


在重大创伤患者中，低钙血症与死亡率增加有关。尽管缺乏因果关系的有力证据，但仍建议早期补充钙。这项研究调查了创伤复苏期间补充钙是否能带来生存益处。我们使用 TraumaRegister DGU® (2015-2019) 的数据进行了回顾性分析，应用倾向评分匹配来平衡有和没有补钙的重大创伤患者之间的人口统计、损伤严重程度和管理。 6 小时死亡率、24 小时死亡率和院内死亡率被视为主要结果参数。在欧洲创伤中心直接入院的 28,323 名成年严重创伤患者中，有 1,593 名（5.6%）接受了钙补充剂。使用多变量逻辑回归生成倾向评分，可以对两组 1447 名患者进行匹配。早期死亡率（6 小时和 24 小时）没有观察到显着差异，而补钙患者的院内死亡率似乎更高（28.3% vs. 24.5%，P = 0.020），尽管根据预测进行调整后并不显着。死亡率（P = 0.244）。在这个匹配的队列中，没有发现证据支持或反对创伤复苏期间补充钙对生存的益处。进一步的研究应侧重于了解重大创伤患者的离子钙水平的动态和动力学，并确定特定情况或亚组是否可以从钙补充剂中受益。