An observational study on effects of hypomagnesemia among critically ill patients at a tertiary care hospital

ABSTRACT

Background: Magnesium is the fourth abundant cation in the human body and second most abundant intracellular cation after potassium and also serving as cofactor in more than 300 enzymatic reactions. Magnesium deficiency is the most commonly overlooked condition in critically ill patients and associated with other coexisting electrolyte abnormalities. The aim of the present study was to evaluate serum magnesium levels in critically ill patients and to correlate with patient outcome and other parameters like length of stay in ICU, ventilator support, APACHE-II score and duration and mortality.Methods: A two years observational study after ethical committee approval was conducted at a tertiary care hospital among critically ill patients admitted in ICU. Serum magnesium levels and other relevant investigations were performed within 24 hours of admission. Patients management and progress were followed till the outcome. The data was analysed by using SPSS software version 16.0 for windows.Results: Total of 150 patients with 102 males and 48 females were enrolled. 97 cases (64.7%) of hypomagnesemia were observed and 11 cases of hypermagnesemia and 42 cases with normal serum magnesium levels were observed. Hypomagnesemia cases were compared with normal cases and found that Hypomagnesemia cases had higher mortality rate, higher APACHE II score, more length of hospital stay and ventilator duration. Significant association was identified with diabetes and chronic alcoholism (p valve <0.05).Conclusions: Monitoring of magnesium levels in critically ill patients has several prognostic and therapeutic implications and should be recommended as a regular parameter as it is commonly out looked condition. Statistically significant association of hypomagnesaemia was found with hypocalcaemia, hypoalbuminaemia, septicaemia, diabetes and chronic alcoholism. Higher APACHE II score is associated with higher mortality and more length of stay in ICU among the cases of hypomagnesaemia.