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Endocrine Abstracts (2019) 65 P92 | DOI: 10.1530/endoabs.65.P92

SFEBES2019 POSTER PRESENTATIONS Bone and calcium (51 abstracts)

Hypercalcaemia management in in-patients in a district general hospital

Sukanya Ghosh & Edward Jude


Tameside and Glossup Integrated Care Trust, Ashton-Under-Lyne, UK


Background: Hypercalcaemia is a common finding in in-patients. Acute hypercalcaemia can be life-threatening; thus proper work-up is pivotal for correct assessment of underlying-cause and management. The European Hypercalcaemia Guidelines 2016 was used as reference.

Aim: Study was undertaken to assess appropriateness in work-up, diagnosis and management of patients with hypercalcaemia according to European Guidelines.

Methods: Patients diagnosed with hypercalcaemia between November 2017 and December 2018 admitted to a DGH across medical and surgical specialities were included in this retrospective study. Data was obtained from medical records for symptoms of hypercalcaemia and biochemical tests (including adjusted-serum-calcium; adj.S.Ca), and patients’ detailed management plans.

Results: 50 patients were included in the study, (17 males; mean age: 76.1 years. Hypercalcaemia was mild in majority of patients (n=43; 84%) (adj.S.Ca ≥2.67 <3.0 mmol/l); than moderate (adj.S.Ca ≥3 <3.5 mmol/l) (n=5;10%) and severe (n=3; 6%) (adj.S.Ca ≥3.5 mmol/l.) 31 patients (62%) demonstrated symptoms of hypercalcaemia. All patients had renal function tests assessed on admission, 98% had phosphate levels measured, but parathyroid hormone (PTH) measured in only in 19(38%) patients and Vitamin D in 32%. ECG was done in 24% and 1 patient had ECG changes. Of the patients who had PTH measured 52% had high PTH-levels, 31% had low, and 15% had normal PTH levels. Of those with high/normal PTH, 76% were referred to an Endocrinologist. 16% had known malignancy. 6% of patients with low PTH had malignancy. Management varied within the group: 14% received intravenous fluids, bisphosphonates 8%, Steroids 8%, Dialysis 2%. 74% had repeat adj.S.calcium after 24 h. No patient had 24 h urine-calcium. Management of hypercalcaemia was appropriate in 60% patients. Only 12% had follow-up with Endocrinology.

Conclusion: Guidelines are poorly followed in in-patients for assessment and management of hypercalcaemia. Training of health care professionals is crucial for delivery of best care to such patients.

Volume 65

Society for Endocrinology BES 2019

Brighton, United Kingdom
11 Nov 2019 - 13 Nov 2019

Society for Endocrinology 

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