Admission hypomagnesemia as a mortality predictor in medical critically ill patients

Introduction

Magnesium is the second most abundant intracellular cation and serves as a cofactor in more than 300 enzymatic reactions. Hypomagnesemia is a common electrolyte imbalance in critically ill patients; yet it is frequently overlooked. Previous studies highlighted the relationship between hypomagnesemia and mortality in these patients [1, 2]. This study was carried out on patients admitted to the critical care unit and seeks to find admission hypomagnesemia's role as a 28-day mortality predictor in medical critically ill patients.

Methods

This is a cohort prospective study with prognostic research recruiting 150 critically ill patients in a major tertiary hospital. Blood samples were collected for estimation of serum total magnesium on admission, and then the patients were followed over 28 days.

Results

This study was conducted consecutively from April to July 2013. Most subjects were male (62%) with mean age 52.6 ± 15.93 years. The occurrence of sepsis (33.3%) and cardiac disturbances (24.7%) were the most common problems among patients. The mean MSOFA score for the hypomagnesemics was higher than the normal group (4.91 ± 4.19 vs. 3.77 ± 3.52). Subgroup analysis in the MSOFA 0 to 7 group had significant P = 0.015 (chi-square) and crude RR = 2.2 (95% CI = 1.19 to 4.06). From survival analysis, the survival mean of hypomagnesemia patients was lower than the normal group (19.4 vs. 22.8 days), and so was the survival percentage (52.7% vs. 74.7%).

Conclusion

There was a high prevalence of hypomagnesemia in medical critically ill patients and it was associated with a high mortality rate.