Hypomagnesemia as a predictor of mortality in critically ill pediatric patients in picu using prism score

ABSTRACT

Background: Magnesium is the fourth most abundant cation in the human body and the second most abundant intracellular cation after potassium. A potential relationship between low magnesium levels and increased mortality has been suggested in the literature. The objectives were to detect prevalence of hypomagnesemia in critically ill children, its association with sepsis and to correlate this with mortality.Methods: This study was an observational study done on 100 children who met the inclusion criteria, admitted to the PICU of Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India. Patients under the study were managed and treated according to their clinical status and supportive traditional treatment.Results: Prevalence of hypomagnesemia in critically ill pediatric patients was 53%. In this study, majority of the cases admitted to PICU were dengue (19%) and bronchopneumonia (15%) which were significantly associated with hypomagnesemia as p value was less than 0.05. As regard prognosis, Mg had an AUC of 0.576 for prediction of mortality whereas the AUC for PRISM score was 0.811. Logistic regression analysis showed that hypomagnesemia is a significant predictor for mortality among critically ill children (p value=0.028) and OR=3.180 (0.854-7.965).Conclusions: Present study has found high prevalence of hypomagnesemia in critically ill patients. Hypomagnesemia was associated with a higher mortality rate in critically ill patients and commonly associated with infections and respiratory diseases. Hypomagnesemia indicated poor outcome and higher mortality rates in critically ill patients.