Does Hypocalcemia Affect Mortality in Patients With Pulmonary Embolism?

Patient in hospital bed. Critical care needed.
Could calcium levels serve as a possible prognostic marker for in-hospital mortality among patients with pulmonary embolism?

Patients with pulmonary embolism and concurrent hypocalcemia had higher in-hospital mortality and complications than those without hypocalcemia, according to the results of a recent study published in the journal BMC Pulmonary Medicine.

This retrospective study examined in-hospital outcomes among patients hospitalized for pulmonary embolism. The data source was the 2017 Nationwide Inpatient Sample, the largest publicly available all-payer inpatient healthcare database in the US. Rates of mortality and complications were compared between those with and without concurrent hypocalcemia.

Among the 187,989 patient records in the Nationwide Inpatient Sample with a diagnosis of pulmonary embolism, 1565 had an additional diagnosis of hypocalcemia. When in-hospital mortality was compared, 12.4% of pulmonary embolism patients with hypocalcemia died in the hospital, compared with 2.95% without hypocalcemia. Additional analyses showed that pulmonary embolism and hypocalcemia patients had 4-times higher odds of in-hospital mortality vs patients with pulmonary embolism only. Furthermore, the incidence rates of acute kidney injury, acute respiratory failure, sepsis, and arrhythmias were also higher in patients with hypocalcemia.

The study authors wrote, “Our study showed that patients with [pulmonary embolism] and hypocalcemia had higher in-hospital mortality compared to those without hypocalcemia.” They added, “The findings of our study may reflect the effectiveness of using calcium as a prognostic marker in patients hospitalized with a pulmonary embolism.”


Murthi M, Shaka H, El-Amir Z, et al. Association of hypocalcemia with in-hospital mortality and complications in patients with acute pulmonary embolism: results from the 2017 Nationwide Inpatient Sample. BMC Pulm Med. 2021;21(1):410. doi:10.1186/s12890-021-01784-0