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• W2895828336 abstract "Abstract BACKGROUND Clinical laboratories measure total calcium and adjust for albumin concentrations to predict calcium status. We compared total and adjusted calcium (Adj-Ca) with ionized calcium (Ca2+) for correct assignment of calcium status. The effect of restriction of Adj-Ca reporting in patients with hypoalbuminemia was determined on the basis of frequency of misclassifications. METHODS Extraction of laboratory results was performed for 24 months. Adj-Ca was calculated from a modified Payne formula. A further prospective data set for 6 months was collected after stopping reporting of Adj-Ca for patients with an albumin &lt;3.0 g/dL. The agreement between Ca2+ and Adj-Ca or total Ca was assessed with Cohen's kappa statistic. RESULTS In 5553 hospitalized patients, 13604 paired Ca2+ results were analyzed retrospectively. Prospective collection in 1113 paired samples was from 450 patients. Adj-Ca was a poor predictor of calcium status compared to the Ca2+ reference standard in both data sets (agreement 56.9% in the first, 65.6% in the second data set). Renal failure and low albumin concentrations were associated with worse agreement between Adj-Ca and Ca2+. Restriction of reporting of Adj-Ca to albumin concentrations &gt;3.0g/dL improved correct classification of calcium status from 65.6% to 77.6% (P &lt; 0.0001). Total Ca performed better than Adj-Ca for low albumin (&lt;3.0g/dL) and performed similarly in samples with albumin &gt;3.0g/dL. CONCLUSIONS Adj-Ca is unreliable for the classification of calcium status in hospital patients when compared to Ca2+. Adj-Ca overestimates calcium for patients with renal impairment and albumin concentrations &lt;3.0g/dL. Restriction of reporting Adj-Ca for albumin below 3.0 g/dL reduces the number of misclassified patients." @default.
• W2895828336 created "2018-10-26" @default.
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• W2895828336 date "2018-12-01" @default.
• W2895828336 modified "2023-10-14" @default.
• W2895828336 title "Misclassification of Calcium Status Based on Albumin-Adjusted Calcium: Studies in a Tertiary Hospital Setting" @default.
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• W2895828336 doi "https://doi.org/10.1373/clinchem.2018.291377" @default.
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