Low Serum Calcium Levels Contribute to Larger Hematoma Volume in Acute Intracerebral Hemorrhage

BACKGROUND AND PURPOSE: We investigate whether admission serum calcium levels are associated with hematoma volume, stroke severity, and outcomes in patients with acute intracerebral hemorrhage. METHODS: A total of 273 patients admitted within 24 hours after intracerebral hemorrhage onset was divided into quartiles based on admission serum calcium levels (Q1 [≤9.0], Q2 [9.1-9.3], Q3 [9.4-9.7], Q4 [≥9.8] mg/dL). RESULTS: Median hematoma volumes for each quartile (Q1 to Q4) were 18, 9, 10, and 9 mL (P=0.005), and median National Institutes of Health Stroke Scale scores were 16, 11, 11, and 9 (P=0.010), respectively. On multivariate analysis, Q1 had larger hematoma volume (P=0.025) and higher National Institutes of Health Stroke Scale score (P=0.020) than Q4. There were fewer patients with modified Rankin Scale scores 0 to 2 in Q1 than Q4 after adjustment for risk factors and comorbidities (odds ratio, 0.31; 95% confidence interval, 0.11-0.84) but not after additional adjustment for hematoma volume and National Institutes of Health Stroke Scale score. There were more patients with modified Rankin Scale scores 5 to 6 (P=0.016) and with fatal outcomes (P=0.048) in Q1 than Q4 as crude values, but not after adjustment. CONCLUSIONS: Low admission serum calcium levels were associated with larger hematoma volume and higher National Institutes of Health Stroke Scale score among patients with acute intracerebral hemorrhage.