Hypocalcemia in trauma patients: A narrative review

Abstract

Hypothermia, acidosis, and coagulopathy together make up the trauma triad of death, which has been acknowledged as a key factor in the demise of trauma patients. Hypocalcemia has recently been added as the fourth element of the "diamond of death" in trauma. However, the effects of hypocalcemia in trauma patients have received insufficient attention from systematic reviews. The primary focus of this review will be the impact of hypocalcemia on the mortality rates among trauma victims. Regardless of a large transfusion, hypocalcemia can occur in trauma patients; this condition is known as "trauma-induced hypocalcemia". Hypocalcemia driven by trauma is multifaceted and linked to the fatal triad, which may worsen or even result in death. Our review showed an association between hypocalcemia and increased mortality. Recent data have introduced hypocalcemia integrated with the trauma lethal triad for predicting the prognosis and mortality of critically traumatized patients. However, the benefit of prophylactic calcium supplementation requires further study to support it.