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Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: Results from a cross-sectional study

      Highlights

      • Hypermagnesemia is markedly associated with early in-hospital mortality.
      • Diuretic therapy revealed to be protective.
      • Hypomagnesemia was not associated with mortality.

      Abstract

      Background

      Patients with electrolyte imbalances or disorders have a high risk of mortality. It is unknown if this finding from sodium or potassium disorders extends to alterations of magnesium levels.

      Methods and patients

      In this cross-sectional analysis, all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland, were included. A multivariable logistic regression model was performed to assess the association between magnesium levels and in-hospital mortality up to 28 days.

      Results

      A total of 22,239 subjects were screened for the study. A total of 5339 patients had plasma magnesium concentrations measured at hospital admission and were included into the analysis. A total of 6.3% of the 352 patients with hypomagnesemia and 36.9% of the 151 patients with hypermagnesemia died. In a multivariate Cox regression model hypermagnesemia (HR 11.6, p < 0.001) was a strong independent risk factor for mortality. In these patients diuretic therapy revealed to be protective (HR 0.5, p = 0.007). Hypomagnesemia was not associated with mortality (p > 0.05). Age was an independent risk factor for mortality (both p < 0.001).

      Conclusion

      The study does demonstrate a possible association between hypermagnesemia measured upon admission in the emergency department, and early in-hospital mortality.

      Keywords

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