Is serum magnesium level associated with atrial fibrillation in the mixed medical/surgical intensive care unit setting?

IF 1.5 4区医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Magnesium research Pub Date : 2022-07-01 DOI:10.1684/mrh.2023.0506

Bişar Ergün, Begüm Ergan, Murat Küçük, Mehmet Nuri Yakar, Mehmet Celal Öztürk, Ferhan Demirer Aydemir, Özlem Öner, Volkan Hanci, Bilgin Cömert, Ali Necati Gökmen

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引用次数: 1

Abstract

Background: Although low serum magnesium level is a a relatively common problem in mixed medical/surgical intensive care units (ICUs), its association with new-onset atrial fibrillation (NOAF) has been studied to a lesser extent. We aimed to investigate the effect of magnesium levels on the development of NOAF in critically ill patients admitted to the mixed medical/surgical ICU.

Methods: A total of 110 eligible patients (45 female, 65 male) were included in this case-control study. The age and sex-matched control group (n = 110) included patients with no atrial fibrillation from admission to discharge or death.

Results: The incidence of NOAF was 2.4% (n = 110) between January 2013 and June 2020. At NOAF onset or the matched time point, median serum magnesium levels were lower in the NOAF group than in the control group (0.84 [0.73-0.93] vs. 0.86 [0.79-0.97] mmol/L; p = 0.025). At NOAF onset or the matched time point, 24.5% (n = 27) in the NOAF group and 12.7% (n = 14) in the control group had hypomagnesemia (p = 0.037). Based on Model 1, multivariable analysis demonstrated magnesium level at NOAF onset or the matched time point (OR: 0.07; 95%CI: 0.01-0.44; p = 0.004), acute kidney injury (OR: 1.88; 95%CI: 1.03-3.40; p = 0.039), and APACHE II (OR: 1.04; 95% CI: 1.01-1.09; p = 0.046) as factors independently associated with an increased risk of NOAF. Based on Model 2, multivariable analysis demonstrated hypomagnesemia at NOAF onset or the matched time point (OR: 2.52; 95% CI: 1.19-5.36; p = 0.016) and APACHE II (OR: 1.04; 95%CI: 1.01-1.09; p = 0.043) as factors independently associated with an increased risk of NOAF. In multivariate analysis for hospital mortality, NOAF was an independent risk factor for hospital mortality (OR: 3.22; 95% CI: 1.69-6.13, p<0.001).

Conclusion: The development of NOAF in critically ill patients increases mortality. Critically ill patients with hypermagnesemia should be carefully evaluated for risk of NOAF.

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在混合内科/外科重症监护病房中，血清镁水平与房颤相关吗?

背景:虽然低血镁水平是内科/外科混合重症监护病房(icu)相对常见的问题，但其与新发心房颤动(NOAF)的关系研究较少。我们旨在探讨镁水平对内科/外科混合ICU重症患者NOAF发展的影响。方法:本病例对照研究共纳入110例符合条件的患者(女性45例，男性65例)。年龄和性别匹配的对照组(n = 110)包括从入院到出院或死亡无房颤的患者。结果:2013年1月至2020年6月NOAF发病率为2.4% (n = 110)。在NOAF发病时或相应时间点，NOAF组血清镁水平中位数低于对照组(0.84 [0.73-0.93]vs. 0.86 [0.79-0.97] mmol/L;P = 0.025)。在NOAF发病或相应时间点，NOAF组低镁血症发生率为24.5% (n = 27)，对照组为12.7% (n = 14) (p = 0.037)。基于模型1，多变量分析表明，在NOAF发病或匹配时间点，镁水平(or: 0.07;95%置信区间:0.01—-0.44;p = 0.004)，急性肾损伤(OR: 1.88;95%置信区间:1.03—-3.40;p = 0.039)， APACHE II (OR: 1.04;95% ci: 1.01-1.09;p = 0.046)是与NOAF风险增加独立相关的因素。基于模型2，多变量分析显示NOAF发病时或匹配时间点存在低镁血症(or: 2.52;95% ci: 1.19-5.36;p = 0.016)和APACHE II (OR: 1.04;95%置信区间:1.01—-1.09;p = 0.043)是与NOAF风险增加独立相关的因素。在医院死亡率的多变量分析中，NOAF是医院死亡率的独立危险因素(OR: 3.22;95% CI: 1.69 ~ 6.13, p结论:危重患者NOAF的发生增加了死亡率。高镁血症危重患者应仔细评估NOAF的风险。

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来源期刊

Magnesium research 医学-内分泌学与代谢

CiteScore

3.50

自引率

9.40%

发文量

审稿时长

>12 weeks

期刊介绍： Magnesium Research, the official journal of the international Society for the Development of Research on Magnesium (SDRM), has been the benchmark journal on the use of magnesium in biomedicine for more than 30 years. This quarterly publication provides regular updates on multinational and multidisciplinary research into magnesium, bringing together original experimental and clinical articles, correspondence, Letters to the Editor, comments on latest news, general features, summaries of relevant articles from other journals, and reports and statements from national and international conferences and symposiums. Indexed in the leading medical databases, Magnesium Research is an essential journal for specialists and general practitioners, for basic and clinical researchers, for practising doctors and academics.