Published: 2021-11-23

Study of effect of serum magnesium concentration on clinical outcome of critically sick patients in medical intensive care unit

Ganedi S. Kumari


Background: Deficiency of magnesium is common and often ignored. It is associated with cardiac irregularity, cardiac insufficiency, seizure and electrolyte imbalance. As this element has multiple functions in our body it is important in the pathophysiology of several critical illnesses in intensive care unit (ICU). Hence the present study was undertaken to determine the usefulness of admission serum magnesium levels with regards to patient outcome considering mortality, need and duration of ventilator support, and acute physiologic assessment and chronic health evaluation 2 (APACHE 2) score.

Methods: Demographic data such as age and sex were recorded. Patients were assessed for presenting complaints, history of other diseases and habits through an interview with the patients or care giver. These findings were recorded on a predesigned proforma patients was followed up for the outcomes such as mortality, need of ventilator support, duration of ICU stay and APACHE 2 score.

Results: Regarding comparison between outcome of patients between two groups, 44% patients with magnesium level <1.7 mg/dl have improved and 72% patient didn’t improve. 44% patients with magnesium level >1.7 mg/dl have improved and 28% patient didn’t improve.

Conclusions: From present observational study we can conclude that hypomagnesaemia is more common in patients more than 50 years of age and with male predominance. Pneumonia with septicaemia and cerebrovascular accident (CVA) was commonly associated with hypomagnesaemia. In present study we have observed that hypomagnesaemia is associated with high APACHE 2 score, poor outcome and more requirement of ventilatory support.


Serum magnesium concentration, Outcome, Critically sick patients

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Zafar MS, Wani JI, Karim R, Mir MM, Koul PA. Significance of serum magnesium levels in critically ill-patients. Int J Appl Basic Med Res. 2014;4(1):34-7.

Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J. 2012;5(1):3-14.

Kumar S, Jain S, Agrawal S, Honmode A. Impact of serum magnesium levels in critically ill elderly patients-A study in a rural teaching hospital. J Clin Gerontol Geriatr. 2016;7(3):104-8.

Swaminathan R. Magnesium metabolism and its disorders. Clin Biochem Rev. 2003;24:47-66.

Deheinzelin D, Negri EM, Tucci MR, Salem MZ, da Cruz VM, Oliveira RM, et al. Hypomagnesemia in critically ill cancer patients: A prospective study of predictive factors. Braz J Med Biol Res. 2000;33:1443-8.

Al-Ghamdi SMG, Cameron EC, Sutton RAL. Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis. 1994;24:737-52.

Hansen BA, Bruserud Ø. Hypomagnesemia in critically ill patients. J Intensive Care. 2018;6(21).

Whang R, Oei TO, Aikawa JK, Watanabe A, Vannatta J, Fryer A, Markanich M. Predictors of clinical hypomagnesemia. Hypokalemia, hypophosphatemia, hyponatremia, and hypocalcemia. Arch Intern Med. 1984;144(9):1794-6.

Wong ET, Rude RK, Singer FR, Shaw ST. A high prevalence of hypomagnesemia and hypermagnesemia in hospitalized patients. Am J Clin Pathol. 1983;79(3):348-52.

Limaye CS, Londhey VA, Nadkart MY, Borges NE. Hypomagnesemia in critically ill medical patients. J Assoc Physicians India. 2011;59:19-22.

Karnik ND, Gupta AV. Hypomagnesemia in ICU. J Assoc Physic India. 2016;64:11.

Velissaris D, Karamouzos V, Pierrakos C, Aretha D, Karanikolas M. Hypomagnesemia in Critically Ill Sepsis Patients. J Clin Med Res. 2015;7(12):911-8.

Chernow B, Bamberger S, Stoiko M, Vadnais M, Mills S, Hoellerich V, Warshaw AL. Hypomagnesemia in patients in postoperative intensive care. Chest. 1989;95:391-7.

Upala S, Jaruvongvanich V, Wijarnpreecha K, Sanguankeo A. Hypomagnesemia and mortality in patients admitted to intensive care unit: a systematic review and meta-analysis. Int J Med. 2016;109(7):453-9.

Bharath MS, Hiregoudar UR. On Admission Hypomagnesemia and its Adverse Effects in Critically Ill Patients Admitted to ICU in Tertiary Care Centre. Int Contemp Med Res. 2016;3(9):43.

Deheinzelin D, Negri EM, Tucci MR, Salem MZ, da Cruz VM, Oliveira RM, Nishimoto IN, Hoelz C. Hypomagnesemia in critically ill cancer patients: a prospective study of predictive factors. Braz J Med Biol Res. 2000;33(12):1443-8.

Jiang P, Lv Q, Lai T, Xu F. Does Hypomagnesemia Impact on the Outcome of Patients Admitted to the Intensive Care Unit? A Systematic Review and Meta-Analysis. Shock. 2017;47(3):288-95.

Pannem RB, Munamala CSR. An observational study on effects of hypomagnesemia among critically ill patients at a tertiary care hospital. Int J Adv Med. 2018;5:1347-51.

Soliman HM, Mercan D, Lobo SS, Mélot C, Vincent JL. Development of ionized hypomagnesemia is associated with higher mortality rates. Crit Care Med. 2003;31(4):1082-7.