A Novel U-Shaped Association Between Serum Magnesium on Admission and 28-Day In-hospital All-Cause Mortality in the Pediatric Intensive Care Unit

Yue, Chao; Zhang, Chun Yi; Huang, Zhen Ling; Ying, Chun

doi:10.3389/fnut.2022.747035

Cited by 3 publications

(3 citation statements)

References 39 publications

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“…However previous studies have found an association of hypomagnesemia with seizures [27,28], we've not found any independent association between these. Rather, convulsion was found associated with hypermagnesemia.…”

Section: Plos Onecontrasting

confidence: 98%

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Prevalence and predictors of magnesium imbalance among critically ill diarrheal children and their outcome in a developing country

Mamun,

Sarmin,

Alam

et al. 2023

PLoS ONE

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Despite having essential roles in maintaining human body physiology, magnesium has gained little attention. We sought to evaluate the prevalence and predictors of magnesium imbalance in diarrheal children admitted to an intensive care unit. This retrospective data analysis was conducted among children admitted between January 2019 and December 2019. Eligible children were categorized by serum magnesium levels that were extracted from the hospital database. Among 557 participants, 29 (5.2%) had hypomagnesemia, 344 (61.8%) had normomagnesemia and 184 (33.0%) had hypermagnesemia. By multivariable multinomial logistic regression, we have identified older children (adjusted multinomial odds ratio, mOR 1.01, 95% CI: 1.004–1.018, p = 0.002) as a predictor of hypomagnesemia. Conversely, younger children (adjusted mOR 0.99, 95% CI: 0.982–0.998, p = 0.02), shorter duration of fever (adjusted mOR 0.92, 95% CI: 0.857–0.996, p = 0.04), convulsion (adjusted mOR 1.55, 95% CI: 1.005–2.380, p = 0.047), dehydration (adjusted mOR 3.27, 95% CI: 2.100–5.087, p<0.001), pneumonia (adjusted mOR 2.65, 95% CI: 1.660–4.240, p<0.001) and acute kidney injury (adjusted mOR 2.70, 95% CI: 1.735–4.200, p<0.001) as the independent predictors of hypermagnesemia. The mortality was higher among children with hypermagnesemia (adjusted mOR 2.31, 95% CI: 1.26–4.25, p = 0.007). Prompt identification and management of the magnesium imbalance among critically ill diarrheal children might have survival benefits, especially in resource-limited settings.

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Section: Plos Onecontrasting

confidence: 98%

“…They have also found an association of hypermagnesemia with increased 28-day mortality [7]. Yue et al have also shown a higher proportion of serum creatinine level among the children admitted in pediatric intensive care unit having higher magnesium level [28].…”

Section: Plos Onementioning

confidence: 95%

Prevalence and predictors of magnesium imbalance among critically ill diarrheal children and their outcome in a developing country

Mamun,

Sarmin,

Alam

et al. 2023

PLoS ONE

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“…Yue et al. found a U-shaped relationship between serum magnesium and 28-day in-hospital all-cause mortality in critically ill children admitted to the pediatric intensive care unit with 0.74–0.93 mmol/L as the optimal serum magnesium range for the lowest risk of mortality [ 26 ]. The similar U-shaped relationships between serum magnesium and mortality no matter in traumatic brain injury patients, kidney transplant recipients or coronary artery disease patients have also been proven in previous studies [ 27–29 ].…”

Section: Discussionmentioning

confidence: 99%

U-shaped association of serum magnesium with mild cognitive impairment among hemodialysis patients: a multicenter study

et al. 2023

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Background The optimal serum magnesium level of patients undergoing hemodialysis (HD) with cognitive impairment is still unclear. This study aimed to evaluate the association between serum magnesium levels and mild cognitive impairment among HD patients. Methods This was a multicenter observational study. Patients undergoing hemodialysis from 22 dialysis centers in Guizhou Province, China were recruited into the study. HD patients were divided into five groups according to serum magnesium quintile. Cognitive function was measured with Mini Mental State Examination. The outcome was an incident mild cognitive impairment (MCI). Multivariate logistic regression analysis, restricted cubic spline and subgroup analysis were applied to explore the association of serum magnesium level with MCI. Results Among 3562 HD patients (mean age 54.3 years, 60.1% male), the prevalence of MCI was 27.2%. After adjusting for confounders, serum magnesium 0.41–0.83 mmol/L [odds ratios (OR) 1.55, 95% confidence interval (CI): 1.10–2.18] had a higher risk of MCI compared with serum magnesium of 1.19–1.45 mmol/L. A U-shaped association was identified between the serum magnesium and incident MCI (P for non-linearity = 0.004). The optimal range of magnesium level with the lowest risk of MCI was 1.12–1.24 mmol/L. As the serum magnesium level was lower than 1.12 mmol/L, the risk of MCI decreased by 24% per standard deviation (SD) increase in serum magnesium (OR 0.76, 95%CI: 0.62–0.93); when the serum magnesium level exceeds 1.24 mmol/L, a rise per SD increased the risk of MCI by 21% (OR = 1.20, 95%CI: 1.02–1.43). Subgroup analyses demonstrated that the associations were robust among individuals with low educational level, smoking, living alone, no working, and without hypertension or diabetes. Conclusions Serum magnesium has a U-shaped association with MCI among HD patients. Both lower and higher serum magnesium can increase the risk of MCI for this population specifically. The optimal serum magnesium range with the lowest risk of MCI was 1.12–1.24 mmol/L.

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Association between Red blood cell distribution width and encephalitis based on the Pediatric Intensive Care Unit database: A Cross-sectional Study

He,

Yang,

zhang

et al. 2024

Preprint

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Background We aimed to explore the association between RDW and encephalitis in Chinese children on Pediatric Intensive Care Unit (PICU) database. Methods In a cross-sectional study, we analyzed a China-based PIC database spanning from 2010 to 2018. Children admitted to the PIC with encephalitis were included as participants to investigate the correlation between RDW and encephalitis. Additionally, multifactorial logistic regression, restricted cubic spline analysis models and stratified analyses were utilized to evaluate this relationship. Results A total of 10185 participants were enrolled, among whom the encephalitis prevalence was 1.7% (173/10185). Multivariate regression models revealed that encephalitis in Chinese children was significantly decreased by 18% with 1% increase in RDW after adjusting for all covariates. (Adjusted OR =0.82, 95% CI: 0.73~0.92). When the RDW was analyzed using quartiles, The adjusted OR (95% CI) of encephalitis for participants in the highest RDW Q4 (≥15.9%) were 0.44 (0.23~0.85), respectively. Compared with individuals with lower RDW Q1 (≤13%) (P for trend = 0.011). The association between RDW and childhood encephalitis was stable in the different subgroups ( P for interaction＞0.05). Interaction analysis revealed no interactive role in the association between RDW and encephalitis of the childhood. Conclusions Our study indicated that RDW was negatively associated with encephalitis in Chinese children. Furthermulticenter prospective studies are needed to validate our findings.

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A Novel U-Shaped Association Between Serum Magnesium on Admission and 28-Day In-hospital All-Cause Mortality in the Pediatric Intensive Care Unit

Cited by 3 publications

References 39 publications

Prevalence and predictors of magnesium imbalance among critically ill diarrheal children and their outcome in a developing country

Prevalence and predictors of magnesium imbalance among critically ill diarrheal children and their outcome in a developing country

U-shaped association of serum magnesium with mild cognitive impairment among hemodialysis patients: a multicenter study

Association between Red blood cell distribution width and encephalitis based on the Pediatric Intensive Care Unit database: A Cross-sectional Study

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