{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T02:57:48Z","timestamp":1770519468889,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T00:00:00Z","timestamp":1576540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The utility of calcium, magnesium and phosphate measurement in the ED is limited. We aimed to determine clinical risk variables for abnormal levels of these electrolytes in order to inform the development of an ordering guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective, observational study of patients who presented to a tertiary referral ED between January and June 2017. Adult patients who had serum calcium, magnesium or phosphate tests completed during their ED stay were included. Presenting symptoms and signs, comorbidities, medication use and laboratory values were extracted from the medical record. Patients with missing data items were excluded. Logistic regression models determined clinical risk variables associated with low and high levels of each electrolyte.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 33\u2009120 adults presented during the study period. Of the 1679 calcium, 1576 magnesium and 1511 phosphate tests, 228 (13.6%), 158 (10.0%) and 387 (25.6%) were abnormal, respectively. Significant risk variables (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) for abnormal levels were: hypocalcaemia \u2013 vomiting, perioral numbness, hand\/foot spasm, calcium and phosphate supplements and chemotherapy (odds ratio [OR] range 5.9\u201317.3); hypercalcaemia \u2013 female sex, vomiting, polyuria, confusion, hyperparathyroidism, cancer and type 1 diabetes (OR range 2.3\u20139.7); hypomagnesemia \u2013 female sex, proton pump inhibitor use, tacrolimus use, alcohol abuse and type 2 diabetes (OR range 2.2\u201313.1); hypermagnesemia \u2013 lethargy, thiazide use and chronic kidney disease (OR range 4.3\u20134.5); hypophosphatemia \u2013 nausea, seizure and glucocorticoid use (OR range 1.7\u20132.1); and hyperphosphataemia \u2013 polyuria, diuretics and chronic kidney disease (OR range 1.9\u20135.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A range of demographic, comorbid, medication and clinical variables are associated with abnormal calcium, magnesium and phosphate levels. These findings will inform the development of clinical guidelines to rationalise calcium, magnesium and phosphate testing. Justification may be required for testing patients with no risk variables.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13411","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T23:39:23Z","timestamp":1576625963000},"page":"303-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Risk variables associated with abnormal calcium, magnesium and phosphate levels among emergency department patients"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-9997","authenticated-orcid":false,"given":"David McD","family":"Taylor","sequence":"first","affiliation":[{"name":"Emergency Department Austin Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A","family":"Date","sequence":"additional","affiliation":[{"name":"Emergency Department Austin Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony","family":"Ugoni","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse L","family":"Smith","sequence":"additional","affiliation":[{"name":"Central Gippsland Health  Sale Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William S","family":"Spencer","sequence":"additional","affiliation":[{"name":"Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik J","family":"de Tonnerre","sequence":"additional","affiliation":[{"name":"Northern Sydney Local Health District NSW Health  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J","family":"Yeoh","sequence":"additional","affiliation":[{"name":"Emergency Department Austin Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2014-003821"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.00723"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.401"},{"key":"e_1_2_7_5_1","unstructured":"National Prescribing Service MedicineWise.Choosing Wisely Australia. 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