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The relationship between magnesium levels and mortality in the respiratory intensive care unit.

ABSTRACT:

Abstract

Magnesium deficiency is defined as a pathophysiologic factor in numerous illnesses. This study aims to define the effects of magnesium levels on patients in the intensive care unit (ICU) regarding length of stay in the ICU, length of mechanical ventilation (MV), and 28-day mortality.The following data were collected during initial assessment of patients admitted to the ICU with acute respiratory failure (ARF). Demographic data, magnesium and potassium levels, Charlson's Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, length of MV, length of hospital stay in the ICU, 28-day mortality, and ICU discharge status.In the initial serum analysis prior to treatment of patients in the ICU, the mortality rate of the patient group with hypermagnesemia was found to be statistically significant when compared with other magnesium levels (P?=?.018). Apart from renal failure, ICU mortality is higher in the hypermagnesemia group than other groups.Hypermagnesemia is an electrolyte abnormality that is generally seen in older individuals and those with serious comorbidity and it can be used in mortality prediction.

SUBMITTER: Cirik MO

PROVIDER: S-EPMC7769377 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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The relationship between magnesium levels and mortality in the respiratory intensive care unit.

Cirik Mustafa Özgür MÖ Kilinç Mukaddes M Doğanay Güler Eraslan GE Ünver Meriç M Yildiz Murat M Avci Sema S

Medicine 20201201 52

<h4>Abstract</h4>Magnesium deficiency is defined as a pathophysiologic factor in numerous illnesses. This study aims to define the effects of magnesium levels on patients in the intensive care unit (ICU) regarding length of stay in the ICU, length of mechanical ventilation (MV), and 28-day mortality.The following data were collected during initial assessment of patients admitted to the ICU with acute respiratory failure (ARF). Demographic data, magnesium and potassium levels, Charlson's Comorbid ...[more]

PMID: 33350723

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Project description:Patients in the intensive care unit (ICU) are at high risk of mortality which is not well predicted. Previous studies noted that leucine has prognostic value in a variety of diseases. This study investigated whether leucine concentration was a useful biomarker of metabolic and nutritional status and 6-month mortality in ICU. We recruited 454 subjects admitted to ICU (348 and 106 in the initiation and validation cohorts, respectively) with an acute physiology and chronic health evaluation (APACHE II) score ≥ 15. We measured plasma leucine concentrations, traditional biomarkers, and calculated APACHE II and sequential organ failure assessment (SOFA) scores. Leucine levels were weakly correlated with albumin, prealbumin, and transferrin levels (r = 0.30, 0.12, and 0.15, p = 0.001, 0.029, and 0.007, respectively). During follow-up, 116 (33.3%) patients died. Compared to patients with leucine levels between 109 and 174 μM, patients with leucine > 174 μM or <109 μM had a lower cumulative survival rate. Death was also associated with age, higher APACHE II and SOFA scores, C-reactive protein, and longer stays in the ICU, but with lower albumin, prealbumin, and transferrin. Patients with leucine levels > 174 μM had higher alanine aminotransferase levels, but no significant differences in other variables; patients with leucine levels < 109 μM had higher APACHE II and SOFA scores, higher incidence of using inotropic agents, longer ICU and hospital stays, but lower albumin and transferrin levels. Multivariable analysis demonstrated that leucine > 174 μM was an independent predictor of mortality, especially early mortality. However, among patients who stayed in ICU longer than two weeks, leucine < 109 μM was an independent predictor of mortality. In addition, leucine < 109 μM was associated with worse ventilator weaning profiles. These findings were similar in the validation cohort. Our study demonstrated a U-shape relationship between leucine levels and mortality rate in ICU.

Project description:PurposeTo systematically review and evaluate the effectiveness of interventions in order to improve the safety and efficiency of patient handover between intensive care unit (ICU) and general ward healthcare professionals at ICU discharge.MethodsPubMed, CINAHL, PsycINFO, EMBASE, Web of Science, and the Cochrane Library were searched for intervention studies with the aim to improve clinical handover between ICU and general ward healthcare professionals that had been published up to and including June 2013. The methods for article inclusion and data analysis were pre-specified and aligned with recommendations outlined in the PRISMA guideline. Two reviewers independently extracted data (study purpose, setting, population, method of sampling, sample size, intervention characteristics, outcome, and implementation activities) and assessed the quality of the included studies.ResultsFrom the 6,591 citations initially extracted from the six databases, we included 11 studies in this review. Of these, six (55 %) reported statistically significant effects. Effective interventions included liaison nurses to improve communication and coordination of care and forms to facilitate timely, complete and accurate handover information. Effective interventions resulted in improved continuity of care (e.g., reduced discharge delay) and in reduced adverse events. Inconsistent effects were observed for use of care, namely, reduction of length of stay versus increase of readmissions to higher care. No statistically significant effects were found in the reduction of mortality. The overall methodological quality of the 11 studies reviewed was relatively low, with an average score of 4.5 out of 11 points.ConclusionsThis review shows that liaison nurses and handover forms are promising interventions to improve the quality of patient handover between the ICU and general ward. More robust evidence is needed on the effectiveness of interventions aiming to improve ICU handover and supportive implementation strategies.

Dataset Information

The relationship between magnesium levels and mortality in the respiratory intensive care unit.

Abstract

Publications

The relationship between magnesium levels and mortality in the respiratory intensive care unit.

Similar Datasets

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