Association between serum magnesium trajectory and in-hospital mortality in hospitalized patients with sepsis: an analysis of the MIMIC-IV database.

IF 1.5 4区 医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY
Xuan Xia, Huan Guo, Hongyu Sun
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Abstract

This study aimed to investigate the association between serum magnesium trajectory and risk of in-hospital mortality in intensive care unit (ICU) patients with sepsis. Adult sepsis patients who had complete data on serum magnesium at ICU admission (at 0, 12, 24, 36 and 48 hours after ICU admission) based the 2012-2019 Medical Information Mart for Intensive Care IV (MIMIC-IV) database were included in this retrospective cohort study. Serum magnesium trajectories were identified using K-means cluster analysis. The multivariable Cox proportional-hazards model was used to evaluate the association between magnesium level at different time points or magnesium trajectory and in-hospital mortality. A total of 2,270 patients with sepsis were enrolled, and in-hospital mortality occurred in 716 (31.54%). Three trajectories were identified: a high-level declining trajectory, normal-level stable trajectory, and low-level rising trajectory. Among the magnesium levels at different time points, a higher serum magnesium level only at ICU admission (0h) (hazard ratio [HR] = 1.13, 95% confidence interval [CI]: 1.03-1.23) was associated with an increased risk of in-hospital mortality. Compared with the normal-level stable trajectory group, patients in the low-level rising trajectory group (HR = 0.82, 95%CI: 0.70-0.97) had a reduced risk of in-hospital mortality, but no association with in-hospital mortality was found in patients in the high-level declining trajectory group (p=0.812). Conclusion: Sepsis patients with a low-level, rising magnesium trajectory may have a reduced risk of in-hospital mortality.

脓毒症住院患者血清镁的变化轨迹与住院死亡率之间的关系:MIMIC-IV 数据库分析。
本研究旨在探讨重症监护病房(ICU)脓毒症患者血清镁的变化轨迹与院内死亡风险之间的关系。这项回顾性队列研究纳入了根据2012-2019年重症监护医学信息市场IV(MIMIC-IV)数据库提供的ICU入院时(ICU入院后0、12、24、36和48小时)血清镁完整数据的成人脓毒症患者。采用 K-均值聚类分析确定了血清镁的变化轨迹。采用多变量 Cox 比例危险模型评估不同时间点的血镁水平或血镁轨迹与院内死亡率之间的关系。共有2270名脓毒症患者入选,其中716人(31.54%)出现院内死亡。研究发现了三种轨迹:高水平下降轨迹、正常水平稳定轨迹和低水平上升轨迹。在不同时间点的血镁水平中,仅在重症监护室入院时(0 小时)血清镁水平较高(危险比 [HR] = 1.13,95% 置信区间 [CI]:1.03-1.23)与院内死亡风险增加有关。与正常水平稳定轨迹组相比,低水平上升轨迹组患者(HR = 0.82,95%CI:0.70-0.97)的院内死亡风险降低,但在高水平下降轨迹组患者中未发现与院内死亡相关的因素(P=0.812)。结论低水平镁升高轨迹的脓毒症患者院内死亡风险可能会降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Magnesium research
Magnesium research 医学-内分泌学与代谢
CiteScore
3.50
自引率
9.40%
发文量
6
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.
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