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Hypomagnesemia in trauma patients
H Frankel1, R Haskell, S Y Lee
1Department of Traumatology, Brandywine Hospital, 201 Reeceville Road, Coatesville, Pennsylvania 19104, USA.
World Journal of Surgery
|August 18, 1999
Summary
Hypomagnesemia is common in injured patients, with 43% showing low magnesium levels. Total magnesium is not a reliable indicator of ionized magnesium in these cases.
Area of Science:
- Trauma care
- Clinical chemistry
- Critical care medicine
Background:
- Hypomagnesemia is a frequent electrolyte disturbance in critically ill patients.
- Accurate assessment of magnesium levels is crucial for appropriate patient management.
- Existing methods for assessing magnesium may have limitations in specific patient populations.
Purpose of the Study:
- To determine the incidence of hypomagnesemia in injured patients compared to a general hospital cohort.
- To compare total magnesium (TMg) and ionized magnesium (IMg) levels.
- To correlate magnesium levels with injury severity and ethanol levels.
Main Methods:
- A descriptive study was conducted at a level II trauma center.
- Consecutive injured patients underwent paired analysis of blood total magnesium (TMg) and ionized magnesium (IMg).
- Pearson correlation coefficients were calculated for IMg versus TMg, Injury Severity Score (ISS), Trauma Score (TS), Glasgow Coma Scale (GCS), and blood units transfused.
Main Results:
- 43% of trauma patients had hypomagnesemia, compared to 30% in a general hospital cohort (p<0.05).
- The correlation between TMg and IMg was weaker at low TMg levels (r(2)=0.35) compared to higher levels (r(2)=0.74).
- No significant correlation was found between IMg and ISS, TS, GCS, units transfused, or ethanol level.
Conclusions:
- Hypomagnesemia is prevalent in injured patients.
- Total magnesium is an unreliable predictor of ionized magnesium, especially at low levels.
- Ionized magnesium determination is recommended for accurate diagnosis and management of hypomagnesemia in trauma patients.