The relationship between magnesium levels and mortality in the respiratory intensive care unit

Abstract

Magnesium deficiency is defined as a pathophysiologic factor in numerous illnesses. This study aims to define the effects of magnesium levels on patients in the intensive care unit (ICU) regarding length of stay in the ICU, length of mechanical ventilation (MV), and 28-day mortality. The following data were collected during initial assessment of patients admitted to the ICU with acute respiratory failure (ARF). Demographic data, magnesium and potassium levels, Charlson's Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, length of MV, length of hospital stay in the ICU, 28-day mortality, and ICU discharge status. In the initial serum analysis prior to treatment of patients in the ICU, the mortality rate of the patient group with hypermagnesemia was found to be statistically significant when compared with other magnesium levels ( P = .018). Apart from renal failure, ICU mortality is higher in the hypermagnesemia group than other groups. Hypermagnesemia is an electrolyte abnormality that is generally seen in older individuals and those with serious comorbidity and it can be used in mortality prediction.

Dysmagnesemia Is the Most Common Disturbance of the Calcium–Magnesium–Phosphorous Balance among Older Hospitalized People in Warsaw

“…The prevalence of hypermagnesemia found in this study is similar to the values described by other investigators, 7% vs. 12% [21]. Although hypermagnesemia is still described as a rare phenomenon in people without renal failure [40], this condition is more common in elderly patients, especially those burdened with severe comorbidities, so its prevalence may have been relatively high in the group of hospitalized patients older than 65 years [18].…”

“…In our study, dyscalcemia was found in 23.5% of the serum calcium test results, dysmagnesemia-in 33% of the serum magnesium test results, dysphosphatemia-in 26% of the serum phosphate test results, and dysvitaminosis D (depending on the adopted reference values)-in 70% (30-50 ng/mL), 46% (20-50 ng/mL), or 25% (10-50 ng/mL) of the serum vitamin D test results. These values are lower than those reported by other authors [15][16][17][18][19][20][21][22]. This may be caused by the fact that we analyzed the general population of hospitalized patients instead of selecting those with calcium, magnesium, or phosphate homeostasis disturbances as a primary cause of hospitalization.…”

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

“…Previous clinical studies have focused on mortality and hypomagnesemia, with the majority of studies focusing on a single type of magnesium abnormal status. Some studies have proposed low magnesium (8)(9)(10) or high magnesium status (11)(12)(13) as risk factors for mortality in ICU patients, while others have shown no association between low magnesium (14)(15)(16)(17) and prognosis in ICU patients, and although hypomagnesemia is associated with mortality, it only occurs after ICU admission (14).…”

The effects of hypomagnesemia on delirium in middle-aged and older adult patients admitted to medical intensive care units

“…Electrolytes are essential components in the human body that maintain the membrane potential of cells, transmit nerve impulses, and sustain intra-and extracellular fluid balance [12,13]. Magnesium is the fourth most abundant electrolyte in the body and is involved in diverse biochemical reactions such as adenosine triphosphate metabolism, muscle contraction and relaxation, blood pressure regulation, neuronal activity, and neurotransmitter release [14,15]. Patients with hypomagnesemia, who account for 20%-65% of all ICU patients, are at a significantly higher risk of prolonged mechanical ventilation and longer ICU stay, ultimately increasing the risk of delirium [14][15][16][17][18].…”

“…Magnesium is the fourth most abundant electrolyte in the body and is involved in diverse biochemical reactions such as adenosine triphosphate metabolism, muscle contraction and relaxation, blood pressure regulation, neuronal activity, and neurotransmitter release [14,15]. Patients with hypomagnesemia, who account for 20%-65% of all ICU patients, are at a significantly higher risk of prolonged mechanical ventilation and longer ICU stay, ultimately increasing the risk of delirium [14][15][16][17][18]. Consistent with the role of magnesium, neurological manifestations such as convulsions and coma, have been reported to be associated with hypomagnesemia [16,18].…”