{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T06:59:39Z","timestamp":1761202779790,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":21,"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":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate the prognostic utility of pH\u2010corrected ionised calcium (ciCa\n                      <jats:sup>2+<\/jats:sup>\n                      ) as calculated by blood gas analysers in major trauma patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of trauma patients aged \u2265\u200916\u2009years with an Injury Severity Score (ISS) \u2265\u200913 presenting to a New Zealand tertiary trauma centre from January 2021 to June 2022. Patients were excluded if they did not meet New Zealand Trauma Registry criteria, received blood products before ionised calcium (iCa\n                      <jats:sup>2+<\/jats:sup>\n                      ) measurement, or had missing key laboratory data. Outcomes were in\u2010hospital mortality, coagulopathy and transfusion. We compared prognostic performance of ciCa\n                      <jats:sup>2+<\/jats:sup>\n                      versus iCa\n                      <jats:sup>2+<\/jats:sup>\n                      using logistic regression and pairwise comparison of receiver operating characteristic curves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 232 patients, 110 (47.4%) had an initial ciCa\n                      <jats:sup>2+<\/jats:sup>\n                      \u2009\u2264\u20091.1\u2009mmol\/L. In unadjusted analysis, ciCa\n                      <jats:sup>2+<\/jats:sup>\n                      \u2009\u2264\u20091.1\u2009mmol\/L was not associated with mortality (OR 2.18, 95% CI 0.99\u20134.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08). After adjusting for age and ISS, lower ciCa\n                      <jats:sup>2+<\/jats:sup>\n                      was independently associated with mortality (aOR per 0.1\u2009mmol\/L increase 0.58, 95% CI 0.35\u20130.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), but this was attenuated after adjusting for lactate (aOR 1.30, 95% CI 0.74\u20132.28;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.37). ciCa\n                      <jats:sup>2+<\/jats:sup>\n                      was strongly associated with coagulopathy (OR 23.0, 95% CI 1.32\u2013395;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and transfusion (OR 2.54, 95% CI 1.41\u20134.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), with superior discrimination over iCa\n                      <jats:sup>2+<\/jats:sup>\n                      for both (AUROC 0.95 vs. 0.56 and 0.69 vs. 0.54, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">\n                        ciCa\n                        <jats:sup>2<\/jats:sup>\n                      <\/jats:styled-content>\n                      <jats:sup>+<\/jats:sup>\n                      outperformed uncorrected iCa\n                      <jats:sup>2+<\/jats:sup>\n                      . As a routine blood gas parameter incorporating key elements of trauma pathophysiology\u2014hypocalcaemia and acidaemia\u2014it may offer a practical tool for early risk stratification in trauma.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70161","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:06:00Z","timestamp":1761116760000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>pH<\/scp>\n                    \u2010Corrected Ionised Calcium Predicts Coagulopathy After Major Trauma: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7486-0877","authenticated-orcid":false,"given":"Nicholas G.","family":"Chapman","sequence":"first","affiliation":[{"name":"Emergency Department, Te Pae Tiaki Wellington Regional Hospital  Wellington New Zealand"},{"name":"The Alfred Emergency &amp; Trauma Centre, Alfred Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2746-4029","authenticated-orcid":false,"given":"Conor S.","family":"O'Flynn","sequence":"additional","affiliation":[{"name":"The Alfred Emergency &amp; Trauma Centre, Alfred Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7888-7284","authenticated-orcid":false,"given":"James E.","family":"Moore","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Wellington Regional Hospital  Wellington New Zealand"},{"name":"Medical Research Institute of New Zealand  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0266-1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003027"},{"key":"e_1_2_11_4_1","first-page":"17","article-title":"An Analysis of the Incidence of Hypocalcaemia in Wartime Trauma Casualties","author":"Escandon M. A.","year":"2022","journal-title":"Medical Journal (Fort Sam Houston, Tex.)"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaa267"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2015-205096"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002614"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2017-206717"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000239516.49799.63"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04541-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111386"},{"issue":"2","key":"e_1_2_11_12_1","first-page":"391","article-title":"Admission Ionized Calcium Levels Predict the Need for Multiple Transfusions: A Prospective Study of 591 Critically Ill Trauma Patients","volume":"70","author":"Magnotti L. J.","year":"2011","journal-title":"Journal of Trauma"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-024-02713-6"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12875"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/JETS.JETS_45_19"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365517209081058"},{"issue":"1463","key":"e_1_2_11_17_1","first-page":"19","article-title":"The New Zealand Major Trauma Registry: The Foundation for a Data\u2010Driven Approach in a Contemporary Trauma System","volume":"130","author":"Isles S.","year":"2017","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-023-02310-z"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/24.9.1545"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000453"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.148.3.6878708"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-05002-1"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2008.23.4.700"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002570"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-024-00572-5"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T06:58:23Z","timestamp":1761202703000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/1742-6723.70161"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70161","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"type":"print","value":"1742-6731"},{"type":"electronic","value":"1742-6723"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70161"}}