High serum magnesium levels in septic patients linked to increased mortality warns new study

Sepsis is one of the most common life-threatening conditions in intensive care units, with approximately 48.9 million cases reported worldwide in 2017, accounting for 19.7% of total global mortality. Given the severity of sepsis, the World Health Organization has classified it as a global health priority.

Early identification and intervention are crucial for the treatment of sepsis and septic shock, significantly impacting patient outcomes. Therefore, conducting risk stratification is particularly important.

A recent international multicenter study led by Dr Bo Hu's team from Wuhan University, China, found a significant association between high serum magnesium levels and increased 28-day mortality in septic patients. The study analyzed data from 10,826 patients with sepsis in the U.S. and China, highlighting the importance of serum magnesium levels for patient risk stratification. The results are published in the journal Medcomm.

Utilizing the large MIMIC-IV database in critical care medicine and a cohort of septic patients from a major tertiary hospital in China, the research collected data on serum magnesium levels, severity scores, and 28-day mortality at the onset of sepsis. The findings indicated that patients with elevated serum magnesium levels exhibited more severe conditions and a significantly increased risk of 28-day mortality. Even after adjusting for potential confounding factors, the association between high serum magnesium levels and increased mortality remained significant.

Furthermore, the study validated the relationship between high serum magnesium levels and increased mortality across different ethnicities and healthcare settings, underscoring the necessity for careful monitoring and intervention of serum magnesium levels in clinical practice.

Serum magnesium plays a crucial role in the pathophysiology of sepsis. Elevated serum magnesium levels are associated with poor outcomes, potentially through mechanisms such as exacerbating hemodynamic instability, impairing neuromuscular transmission, affecting respiratory function, and intensifying inflammatory responses, which can further worsen the pathological process of sepsis. Therefore, future researches need to delve deeper into the specific mechanisms by which serum magnesium influences the pathophysiology of sepsis.

This study confirms the association between high serum magnesium levels and increased mortality in septic patients, while also suggesting that serum magnesium levels may serve as a valuable indicator for identifying high-risk patients. This discovery has significant implications for clinical treatment and may provide new tools for assessing the prognosis of patients with sepsis, helping clinicians develop more effective treatment strategies.

Reference:

Le Li, Li Li, Qiuyue Zhao, Xiao Liu, Yaohui Liu, Kailin Guo, Dongsu Zhang, Chang Hu, Bo Hu, High serum magnesium level is associated with increased mortality in patients with sepsis: an international, multicenter retrospective study, MedComm, https://doi.org/10.1002/mco2.713.