title: Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: results from a cross-sectional study.
abstract: BACKGROUND
  Patients with electrolyte imbalances or disorders have a high risk of mortality. It is unknown if this finding from sodium or potassium disorders extends to alterations of magnesium levels.
  
  
  METHODS
  In this cross-sectional analysis, all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland, were included. A multivariable logistic regression model was performed to assess the association between magnesium levels and in-hospital mortality up to 28days.
  
  
  RESULTS
  A total of 22,239 subjects were screened for the study. A total of 5339 patients had plasma magnesium concentrations measured at hospital admission and were included into the analysis. A total of 6.3% of the 352 patients with hypomagnesemia and 36.9% of the 151 patients with hypermagnesemia died. In a multivariate Cox regression model hypermagnesemia (HR 11.6, p<0.001) was a strong independent risk factor for mortality. In these patients diuretic therapy revealed to be protective (HR 0.5, p=0.007). Hypomagnesemia was not associated with mortality (p>0.05). Age was an independent risk factor for mortality (both p<0.001).
  
  
  CONCLUSIONS
  The study does demonstrate a possible association between hypermagnesemia measured upon admission in the emergency department, and early in-hospital mortality.
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland. Electronic address: dominikhaider2003@yahoo.de.
authors.forename: Dominik G
authors.initials: DG
authors.lastname: Haider
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland.
authors.forename: Gregor
authors.initials: G
authors.lastname: Lindner
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland.
authors.forename: Sufian S
authors.initials: SS
authors.lastname: Ahmad
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sauter
authors.affiliation: Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Wolzt
authors.affiliation: Center of Laboratory Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.
authors.forename: Alexander Benedikt
authors.initials: AB
authors.lastname: Leichtle
authors.affiliation: Center of Laboratory Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.
authors.forename: Georg-Martin
authors.initials: GM
authors.lastname: Fiedler
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland.
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
authors.affiliation: Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Martinistraße 5220246 Hamburg, Germany.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuhrmann
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D013557:Switzerland
chemical_list: D008274:Magnesium
keywords: Critically ill; Emergency room; Hypermagnesemia; Hypomagnesemia; Mortality; Normomagnesemia