Effect of Serum Ionic Magnesium on Neurological Outcome in Severe Traumatic Brain Injury Patients: A Prospective Study

Abstract

Background Magnesium is considered to have important role in cytotoxic and reperfusion pathways, deficiency of which may lead to secondary brain injuries; thus, hypomagnesemia is thought to be detrimental in traumatic brain injury (TBI) patients. The aim of this study was to evaluate the relationship between serum ionic magnesium level and neurological outcome in severe TBI patients. Materials and Methods Eighty-four patients with severe TBI aged between 20 and 80 years admitted within 24 hours of injury included in our study. All patients were divided into two categories on the basis of initial serum magnesium levels as low serum magnesium level and normal serum magnesium level. Data was collected on the basis of age, gender, Glasgow Coma Scale (GCS) at the time of admission, and neurological outcome evaluation done on the basis of Glasgow Outcome Scale (GOS) at the end of 6 months. Results Among the total patients, 32 patients had low serum magnesium level (< 1.6 mg/dL) at the time of admission. About 87.5% patients with low serum magnesium level had poor neurological outcome as compared to 12.5% of patients (p < 0.001) had good neurological outcome evaluated on the basis of GOS. Logistic regression model identified low Mg level (odds ratio = 6.593, p = 0.002) and GCS score less than 5 (odds ratio = 3.099, p = 0.028) as independent predictors of TBI. Conclusion Hypomagnesemia seems to be an independent prognostic marker in severe TBI that can lead to poorer outcomes.