Hypomagnesemia and its clinical outcome: a prospective observational study in a tertiary care hospital in Bangladesh

Background: The most underdiagnosed electrolyte disorder is hypomagnesemia, which occurs due to a lack of magnesium in the body. Hypomagnesemia is a common condition in severely ill patients, along with many other electrolyte abnormalities, such as hypokalemia, hypocalcemia, and hyponatremia. Hypomagnesemia, if not identified and corrected at the appropriate time, can cause life-threatening complications and an increase in mortality. Aims and objectives: To investigate the relationship between hypomagnesemia and patient outcomes in critically ill individuals, along with other criteria: age, sex, primary medical conditions, electrolytes, Acute Physiology and Chronic Health Evaluation-II (APACHE II) scores, Sequential Organ Failure Assessment (SOFA) scores, Charlson Comorbidity Index, ventilator support, intensive care unit (ICU) stay length, and mortality rate in the critical care unit after admission. Materials and methods: A single-center, prospective observational study was conducted in the ICU department of a tertiary care hospital. The study duration was from 1 July 2024 to 31 December 2024. Patients aged 18–80 years, of either gender, who were among the severely ill patients admitted to the ICU, were included in the study. Within 24 hours of hospitalization, serum magnesium levels and other tests were performed. Patient care and progress were closely monitored until the outcome was achieved. SPSS 27 was used to analyze the data. Results: Of the 81 patients in critical condition, 32 (39.5%) had hypomagnesemia, 40 (47.3%) had normomagnesemia, and 9 (11.1%) had hypermagnesemia. In patients with hypomagnesemia, the mean serum magnesium level was 1.26 ± 0.28 mg/dl. The mean APACHE II score was 16.96 ± 7.19, SOFA was 5.59 ± 2.83, and the mean ICU stay was 6.21 ± 2.09 days. Common comorbidities were hypertension in 27 patients (54%) and diabetes mellitus in 21 patients (41.2%) in the hypomagnesemia group. Higher mortality (11 patients, 34.37%) was associated with hypomagnesemia, and sepsis (12.3%) was the most common cause. Conclusions: A longer ICU length of stay was associated with hypomagnesemia, APACHE II and SOFA scores, other electrolyte abnormalities, and high mortality.