Initial Serum Magnesium Level Is Associated with Mortality Risk in Traumatic Brain Injury Patients

Wang, Ruoran; He, Min; Xu, Jianguo

doi:10.3390/nu14194174

Cited by 5 publications

(7 citation statements)

References 46 publications

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“…The study concluded that patients with TBI and abnormally low or high serum magnesium levels had an increased risk of mortality. In agreement with our findings, Wang et al [ 24 ] concluded that higher initial serum magnesium level is independently associated with mortality in TBI patients.…”

Section: Discussionsupporting

confidence: 94%

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Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

et al. 2023

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Background: We sought to evaluate the predictor role of the initial serum level of calcium and magnesium in hospitalized traumatic brain injury (TBI) patients. Materials and methods: A retrospective analysis of all TBI patients admitted to the Hamad Trauma Center (HTC), between June 2016 and May 2021 was conducted. Initial serum electrolyte levels of TBI patients were obtained. A comparative analysis of clinical variables between patients with abnormal and normal serum electrolyte level was performed. Logistic regression analysis with the variables that showed a significant difference (p < 0.05) in the bivariate analysis was performed to calculate the odds ratios (OR) for mortality. Results: There was a total of 922 patients with clinical records of serum electrolyte levels at admission. Of these, 757 (82.1%) had hypocalcemia, 158 (17.1%) had normal calcium level, and 7 (0.8%) had hypercalcemia. On the other hand, 616 (66.8%) patients had normal magnesium level, 285 (30.9%) had hypomagnesemia, and 12 (1.3%) had hypermagnesemia. The mortality rate in hypocalcemia group was 24% while in patients with normal calcium level it was 12%, p = 0.001. Proportionate mortality rates in hypomagnesemia and normal magnesium groups were 15% and 23% (p = 0.006), respectively. On the other hand, 7 out of 12 (58%) hypermagnesemia patients died during the index hospitalization. The regression model including GCS, ISS, PT, aPTT, INR, Hemoglobin, Bicarbonate, Lactate, Sodium, Potassium, Calcium, Magnesium, and Phosphate showed that hypocalcemia was not a significant predictor [OR 0.59 (CI 95%: 0.20–1.35)] of mortality after TBI. However, hypermagnesemia was a significant predictor [OR 16 (CI 95%: 2.1–111)] in addition to the GCS, ISS, aPTT, Bicarbonate, and Lactate values on admission. Conclusion: Although hypocalcemia and hypomagnesemia are common in hospitalized TBI patients, hypocalcemia was not a significant predictor of mortality, while hypermagnesemia was an independent predictor. Further studies with larger sample size and with prospective design are required to support these findings and their importance.

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Section: Discussionsupporting

confidence: 94%

“…Recently, Wang et al [ 24 ] studied the relationship between early serum magnesium levels and mortality of TBI patients. Multivariate regression analysis showed that serum magnesium level was positively associated with mortality after adjusting the confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

et al. 2023

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“…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 ]. In this study, we found that the optimal serum magnesium threshold range for the lowest risk of MCI was 1.12–1.24 mmol/L.…”

Section: Discussionsupporting

confidence: 77%

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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“…Few studies have addressed serum magnesium levels and clinical outcomes in the neurointensive care unit. Wang et al [ 119 ] investigated the association between initial serum magnesium levels and mortality in traumatic brain injury patients (TBI). The study included 2280 adult patients with an abbreviated injury score greater than 3.…”

Section: Discussionmentioning

confidence: 99%

Role of Magnesium in the Intensive Care Unit and Immunomodulation: A Literature Review

et al. 2023

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Both the role and the importance of magnesium in clinical practice have grown considerably in recent years. Emerging evidence suggests an association between loss of magnesium homeostasis and increased mortality in the critical care setting. The underlying mechanism is still unclear, but an increasing number of in vivo and in vitro studies on magnesium’s immunomodulating capabilities may shed some light on the matter. This review aims to discuss the evidence behind magnesium homeostasis in critically ill patients, and its link with intensive care unit mortality via a likely magnesium-induced dysregulation of the immune response. The underlying pathogenetic mechanisms, and their implications for clinical outcomes, are discussed. The available evidence strongly supports the crucial role of magnesium in immune system regulation and inflammatory response. The loss of magnesium homeostasis has been associated with an elevated risk of bacterial infections, exacerbated sepsis progression, and detrimental effects on the cardiac, respiratory, neurological, and renal systems, ultimately leading to increased mortality. However, magnesium supplementation has been shown to be beneficial in these conditions, highlighting the importance of maintaining adequate magnesium levels in the intensive care setting.

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Initial Serum Magnesium Level Is Associated with Mortality Risk in Traumatic Brain Injury Patients

Cited by 5 publications

References 46 publications

Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

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

Role of Magnesium in the Intensive Care Unit and Immunomodulation: A Literature Review

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