Prevalence of admission hypomagnesemia in critically ill patients

Abstract

Introduction:In critically ill patients, hypomagnesemia is a serious but underdiagnosed electrolyte abnormality. There are several studies to assess the prevalence of hypomagnesemia in these patients and its effects on mortality and morbidity. The majority of these experiments were performed in intensive care units for patients with medical and surgical complications, postoperative patients, cardiac intensive care units, or patients with serious cancer.Aims: To co-relate low serum Magnesium levels with the following outcomes in critically ill medical patients admitted to ICU.Materials and methods:A hospital based  cross sectional  study in Patients  attending the Medical Intensive Care unit in Osmania General Hospital for a period of two years from September 2012-September 2014. 160 patients of age more than 18 years with Critically ill medical patients with various medical illnesses and APACHE II score more than 20 were selected study.Results: Out of 160 patients on admission, 106(66.3%) patients had hypomagnesemia, and 54 (33.7%) had normal serum magnesium levels. The mortality rate in hypomagnesemia group was 64.8%; whereas in normomagnesemia group was 35.2% Significantly greater mortality rate was observed in hypomagnesemic patients as compared to normomagnesemic patients (p=0.058). of 106 patients with hypomagnesemia, 73(69%) also had hypocalcemia. Of 54 patients with normal magnesium levels, 28(52%) had  hypocalcemia (p=0.03). Of 106 patients with hypomagnesemia 84(80%) had hypoalbuminemia. 34 (63%) cases of normomagnesemic patients had hypoalbuminemia which is significant.Conclusion: Early diagnosis of hypomagnesemia in critically ill patients is a must to avoid adverse outcomes. Monitoring of serum magnesium levels may have prognostic, perhaps therapeutic implications. High incidence of hypomagnesemia should be kept in mind while treating critically ill patients.