Endocrine Abstracts

Background and aims: Hypercalcemia is a rare ionic disorder and is often overlooked. The aim of this study was to describe the annual incidence of hypercalcemia in the adult population in Spain during a period of fifteen years, using the International Classification of Diseases, 9th Revision Clinical Modification (ICD-9). The diseases and procedures associated with this condition were also assessed.

Materials and methods: Data from the Minimum Basic Data Set of discharged patients older than 14 years old from the Spanish National Health System (Ministry of Health Affairs) between 2001 and 2015 were analyzed to describe the profile of patients with diagnostic codification of hypercalcemia (ICD-9: 275.42).

Results: 41,075 unique patients were identified. The annual incidence is shown in Table 1. 22.3 % of the patients had no identifiable cause of hypercalcemia. 91 % of patients with known causes of hypercalcemia had one reported, 8 % had two, and 1 % had three or more. The most common identifiable causes were: neoplasia 87.8 %, hyperparathyroidism 15.3 %, thyrotoxicosis 2.1 %, parenteral nutrition 1.5 %, sarcoidosis 0.9 %, A-D vitamin poisoning 0.4 %, adrenal insufficiency 0.4 %, thiazide poisoning 0.3 %. Among the neoplastic causes, the most common were: lung cancer 19.8 %, multiple myeloma 14.7 %, breast cancer 6.9 %, gastrointestinal duct cancer 5.1 %, lymphoma 3.9 %, kidney cancer 3.7 %, bladder cancer 3.6 %, hepatobiliopancreatic cancer 3.6 %, prostate cancer 2.8 %. Among cancer patients, 50.6 % had metastatic spread: bone 53.5 %, liver 39 %, lung 27.4 %, serosa 15.1 %, central nervous system 9 %, other 46.7 %. Others conditions associated with hypercalcemia were: acute kidney failure 18.4 %, delirium 6.7 %, lithiasis 1.6 %, phosphorus disorders 0.9 %, magnesium disorders 0.9 %. In-hospital mortality was 26.9 %.

Conclusions: The annual incidence of hypercalcemia among the admitted patients in the Spanish National Health System had a notable and constant increase between 2007 and 2015. The actual incidence is probably higher as this condition is underreported. The most common etiologies are neoplastic disorders, followed by hyperparathyroidism.