Article Impact Level: HIGH Data Quality: STRONG Summary of MedComm, 5(10), e713. https://doi.org/10.1002/mco2.713 Dr. Le Li et al.
Points
- This study analyzed the association between serum magnesium levels and 28-day mortality in septic patients using data from two large cohorts: MIMIC-IV (9,099 patients) and a Chinese cohort (1,727 patients).
- Higher serum magnesium levels were linked to increased mortality risk in both cohorts, with a linear increase observed in the MIMIC-IV cohort and a J-shaped relationship in the Chinese cohort.
- Patients with elevated serum magnesium had higher disease severity scores and worse laboratory parameters, with mortality rates of 27.8% in the highest quintile in MIMIC-IV and 20% in the highest group in the Chinese cohort.
- In both cohorts, the Kaplan–Meier survival analysis showed significant survival differences across serum magnesium groups.
- Multivariate analysis confirmed that higher serum magnesium levels significantly increased the odds of 28-day mortality, highlighting the importance of monitoring magnesium in sepsis management.
Summary
This study examines the association between serum magnesium levels and all-cause mortality in septic patients, analyzing data from two large cohorts: the American Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, with 9,099 patients and a Chinese cohort of 1,727 patients. Participants were divided into five groups based on serum magnesium quintiles. Both cohorts demonstrated that higher serum magnesium levels were associated with an increased risk of 28-day mortality. In the MIMIC-IV cohort, the restricted cubic spline (RCS) curve showed a linear increase in mortality risk with higher serum magnesium levels. At the same time, a J-shaped relationship was observed in the Chinese cohort. These findings suggest that serum magnesium is a potential marker for mortality risk in septic patients.
At baseline, patients with elevated serum magnesium in both cohorts had higher disease severity scores and worse laboratory parameters. In the MIMIC-IV cohort, patients in the highest quintile of serum magnesium (Q5) had 27.8% mortality, compared to 17.8% in the lowest quintile (Q1) (p < 0.001). Similarly, in the Chinese cohort, patients in the highest group (G5) had a mortality rate of 20%, significantly higher than the 16% overall mortality rate (p = 0.004). Kaplan–Meier survival analysis revealed significant differences in survival probabilities across magnesium groups in both cohorts.
Multivariate analysis adjusted for clinical factors confirmed that higher serum magnesium levels were significantly associated with 28-day mortality. In the MIMIC-IV cohort, each unit increase in serum magnesium raised the odds of 28-day mortality by 47% (OR = 1.47, 95% CI: 1.12–1.93, p = 0.005). A similar increase was observed in the Chinese cohort, with each unit rise in serum magnesium linked to a 93% increase in 28-day mortality risk (OR = 1.93, 95% CI: 1.04–3.57, p = 0.037). These findings underscore the importance of monitoring serum magnesium in sepsis management.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/mco2.713
References Li, L., Li, L., Zhao, Q., Liu, X., Liu, Y., Guo, K., Zhang, D., Hu, C., & Hu, B. (2024). High serum magnesium level is associated with increased mortality in patients with sepsis: An international, multicenter retrospective study. MedComm, 5(10), e713. https://doi.org/10.1002/mco2.713
