Association between Serum Magnesium Levels and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients

A bstract Background: Chronic obstructive pulmonary disease (COPD) is a significant respiratory disorder characterized by chronic inflammation and airflow limitation, leading to acute exacerbations that affect the morbidity and mortality. Identifying biomarkers for predicting exacerbation frequency is crucial for improving patient outcomes. In India, COPD is primarily associated with smoking and environmental pollutants. Magnesium plays a vital role in respiratory health and may influence exacerbation severity. Objective: This study investigates the relationship between serum magnesium levels and acute exacerbations in COPD patients. Materials and Methods: We conducted a retrospective analysis of patients with acute COPD exacerbations. Inclusion criteria required patients to be over 40 years; and those requiring intubation, with specific comorbidities, or on certain medications were excluded. We collected demographic and clinical data and measured serum magnesium levels, defining hypomagnesemia as levels below 1.7 mg/dL. Results: The study involved 100 patients (mean age 61.1 ± 10.7 years, 80% male). Common symptoms included breathlessness (98%), cough (90%), and expectoration (65%). Chest X-ray findings indicated 40% with emphysema and 19% with infiltrates. In terms of serum magnesium, 57 patients with hypomagnesemia had longer hospital stay, with 82.5% staying over 7 days, while 46.5% of 43 normomagnesemia patients stayed for 7 days or less ( χ ² = 7.129, P = 0.007). Also, 63.2% of hypomagnesemic patients experienced severe exacerbations compared to 30.2% of normomagnesemic patients ( χ ² = 8.456, P = 0.004). Conclusion: Low serum magnesium levels are significantly associated with increased severity of acute exacerbations in COPD patients and prolonged hospital stay. Monitoring and addressing magnesium levels may enhance COPD management and improve patient outcomes.