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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Internal MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Impact of diuretic therapy-associated electrolyte disorders present on admission to the emergency department: a cross-sectional analysis.BMC Med. 2013; 11
- Incidence and prognosis of dysnatremias present on ICU admission.Intensive Care Med. 2010; 36: 304-311
- Hypernatremic dehydration in nursing home patients: an indicator of neglect.J Am Geriatr Soc. 1983; 31: 466-471
- Age and gender as risk factors for hyponatremia and hypernatremia.Clin Chim Acta. 2003; 337: 169-172
- Hypernatremia in critically ill patients.J Crit Care. 2013; 28: e211-e220
- Temporary scaffolding of coronary arteries with bioabsorbable magnesium stents: a prospective, non-randomised multicentre trial.Lancet. 2007; 369: 1869-1875
- Intravenous magnesium sulfate for acute termination of sustained monomorphic ventricular tachycardia associated with coronary artery disease.Am J Cardiol. 2000; 86: 1270-1272
- Intravenous magnesium therapy for moderate to severe pediatric asthma: results of a randomised, placebo-controlled trial.J Pediatr. 1996; 129: 809-814
- Intravenous magnesium sulfate as an adjunct in the treatment of acute asthma.Chest. 1995; 107: 1576-1581
- Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial.Lancet. 1995; 345: 1455-1463
- The relationship between hypomagnesemia, metformin therapy and cardiovascular disease complicating type 2 diabetes: the Fremantle Diabetes Study.PLoS One. 2013; 8: e74355
- Hypomagnesemia and the risk of death and GFR decline in chronic kidney disease.Am J Med. Sep 2013; 126: 825-831
- A more accurate methode to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group.Ann Intern Med. 1999; 130: 461-470
- Hypomagnesemia as a risk factor for the non-recovery of the renal function in critically ill patients with acute kidney injury.Nephrol Dial Transplant. 2013; 28: 910-916
- Clinical and prognostic significance of serum magnesium concentration in patients with severe chronic congestive heart failure: the PROMISE Study.J Am Coll Cardiol. 1993; 21: 634-640
- Prognostic importance of the serum magnesium concentration in patients with congestive heart failure.J Am Coll Cardiol. 1990; 16: 827-831
- Potassium and magnesium abnormalities: diuretics and arrhythmias in hypertension.Am J Med. 1984; 77: 28-32
- Renal magnesium handling: new insights in understanding old problems.Kidney Int. 1997; 52: 1180-1195
- Diuretic-induced hyponatremia and osteoporotic fractures in patients admitted to the emergency department.Maturitas. 2013; 75: 81-86
- Food and nutrition board. Dietary reference intakes: calcium, phosphorus, magnesium, vitamin D and fluoride.National Academy Press, Washington, DC2004
Article info
Publication history
Published online: June 03, 2015
Accepted:
May 20,
2015
Received in revised form:
May 17,
2015
Received:
February 10,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
