Journal article
Determinants of survival in patients with calciphylaxis: a multivariate analysis
Surgery, Vol.146(6), pp.1028-1034
12/2009
DOI: 10.1016/j.surg.2009.09.022
PMID: 19958929
Abstract
Our study aims to assess the factors affecting survival in patients with calciphylaxis.
We identified 26 patients with biopsy-proven calciphylaxis treated between 1995 and 2007. Clinical and follow-up data were obtained from medical records. Cox proportional hazards models were used to assess the factors affecting survival.
The study group consisted of 23 women and 3 men with a mean age of 56.4 +/- 12.9 years. All patients had multiple comorbidities/risk factors including coronary artery disease (58%), diabetes mellitus (58%), and peripheral vascular disease (23%). Mean laboratory values were: calcium, 9.0 mg/dL (range, 6.8-11.6); albumin, 2.8 mg/dL; phosphate, 4.5 mg/dL (range, 2.5-7.5); Ca *phosphate, 35.9; and parathyroid hormone, 320.9 pg/mL (range, 4.6-2,419). Parathyroidectomy was performed in 9 of 26 patients (35%). Of our patients, 19% underwent revascularization procedures and 58% underwent debridement. In multivariate analyses, factors associated with poor survival were female gender ( P = .01), increased weight ( P = .01), and need for vascular procedures ( P = .06). Improved survival was associated with operative debridement ( P = .01). Parathyroidectomy alone did not emerge as a determinant of patient survival, although there was a trend to improved survival when debridement and parathyroidectomy were combined ( P = .09).
Rather than a single intervention such as parathyroidectomy, a multidisciplinary approach involving early diagnosis, aggressive medical management, operative debridement, and parathyroidectomy may improve survival in calciphylaxis.
Details
- Title: Subtitle
- Determinants of survival in patients with calciphylaxis: a multivariate analysis
- Creators
- Geeta Lal - Department of Surgery, University of Iowa Hospitals, Iowa City, IA 52242, USA. Geeta-lal@uiowa.eduAndrew G NowellJunlin LiaoSonia L SuggRonald J WeigelJames R Howe
- Resource Type
- Journal article
- Publication Details
- Surgery, Vol.146(6), pp.1028-1034
- Publisher
- United States
- DOI
- 10.1016/j.surg.2009.09.022
- PMID
- 19958929
- ISSN
- 0039-6060
- eISSN
- 1532-7361
- Language
- English
- Date published
- 12/2009
- Academic Unit
- Molecular Physiology and Biophysics; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Surgery; Biochemistry and Molecular Biology
- Record Identifier
- 9984025286202771
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