Background Electrolyte disorders are prevalent in patients with sepsis-induced coagulopathy (SIC). The aim of this study was to explore the association between serum calcium levels and mortality in patients with SIC.

Methods We screened the Medical Information Market for Intensive Care III database for the data of patients with SIC. Logistic regression analysis was performed to explore the risk factors for mortality in patients with SIC, and restricted cubic spline (RCS) was applied to fit the correlation between the serum calcium levels and SIC mortality.

Results The in-hospital mortality of patients with SIC was 32.2%. The mortality rate of patients in the first and third tertiles of serum calcium levels was higher than that of patients in the second tertile of serum calcium levels. Results of the univariate regression analysis revealed that serum calcium levels were not associated with mortality. The unadjusted RCS suggested a U-shaped relationship between serum calcium level and mortality. After adjusting for confounding factors, multivariate regression analysis revealed that the relationship between serum calcium level and mortality remained U-shaped.

Conclusion The incidence of mortality was high among patients with SIC who had abnormally low or high serum calcium levels. Physicians should pay attention to the clinical management of patients with SIC, especially hypercalcemia.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The data for this study are from the MIMIC database established by the Beth Israel Deaconess Medical Center (BIDMC). The database was approved by the Institutional Review Board of MIT and BIDMC. To protect privacy, all patients in this database are anonymous.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes