Association of magnesium sulfate use with mortality in critically ill patients with sepsis: a retrospective propensity score-matched cohort study

作者全名："Gu, Wan-Jie; Duan, Xiang-Jie; Liu, Xiao-Zhu; Cen, Yun; Tao, Li-Yuan; Lyu, Jun; Yin, Hai-Yan"

作者地址："[Gu, Wan-Jie; Cen, Yun; Yin, Hai-Yan] Jinan Univ, Affiliated Hosp 1, Dept Intens Care Unit, Guangzhou, Peoples R China; [Gu, Wan-Jie; Lyu, Jun] Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China; [Duan, Xiang-Jie] First Peoples Hosp Changde City, Dept Infect Dis, Changde, Peoples R China; [Liu, Xiao-Zhu] Chongqing Med Univ, Med Data Sci Acad, Chongqing, Peoples R China; [Tao, Li-Yuan] Peking Univ Third Hosp, Res Ctr Clin Epidemiol, Beijing, Peoples R China"

通信作者："Yin, HY (通讯作者)，Jinan Univ, Affiliated Hosp 1, Dept Intens Care Unit, Guangzhou, Peoples R China.; Lyu, J (通讯作者)，Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China."

来源：BRITISH JOURNAL OF ANAESTHESIA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001098585000001

JCR分区：Q1

影响因子：9.8

年份：2023

卷号：131

期号：5

开始页：861

结束页：870

文献类型：Article

关键词：critical illness; death; hypomagnesaemia; magnesium sulfate; sepsis

摘要："Background: Trials have demonstrated lower rates of acute kidney injury in critically ill patients receiving magnesium supplementation, but they have yielded conflicting results regarding mortality.Methods: This is a retrospective cohort study based on the MIMIC-IV (Medical Information Mart in Intensive Care-IV) database. Adult critically ill patients with sepsis were included in the analysis. The exposure was magnesium sulfate use during ICU stay. The primary outcome was 28-day all-cause mortality. Propensity score matching (PSM) was conducted at a 1:1 ratio. Multivariable analyses were used to adjust for confounders.Results: The pre-matched and propensity score-matched cohorts included 10 999 and 6052 patients, respectively. In the PSM analysis, 28-day all-cause mortality rate was 20.2% (611/3026) in the magnesium sulfate use group and 25.0% (757/ 3026) in the no use group. Magnesium sulfate use was associated with lower 28-day all-cause mortality (hazard ratio [HR], 0.70; 95% CI, 0.61-0.79; P<0.001). Lower mortality was observed regardless of baseline serum magnesium status: for hypomagnesaemia, HR, 0.64; 95% confidence interval (CI), 0.45-0.93; P=0.020; for normomagnesaemia, HR, 0.70; 95% CI, 0.61-0.80; P<0.001. Magnesium sulfate use was also associated with lower ICU mortality (odds ratio [OR], 0.52; 95% CI, 0.42-0.64; P<0.001), lower in-hospital mortality (OR, 0.65; 95% CI, 0.55-0.77; P<0.001), and renal replacement therapy (OR, 0.67; 95% CI, 0.52-0.87; P=0.002). A sensitivity analysis using the entire cohort also demonstrated lower 28-day all-cause mortality (HR, 0.62; 95% CI, 0.56-0.69; P<0.001). Conclusions: Magnesium sulfate use was associated with lower mortality in critically ill patients with sepsis. Prospective studies are needed to verify this finding."

基金机构："National Natural Science Foundation of China [82072232]; Science and Technology Program of Guangzhou, China [202201020028]; Special Projects in Key Areas of General Colleges and Universities in Guangdong Province [2022ZDZX2003]; 2021 Annual Medical Teaching Education Management Reform Research Project of Jinan University [2021YXJG029]; Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University, China [JNU1AF-CFTP-2022-a01235]; Science and Technology Projects in Guangzhou, China [202201020054, 2023A03J1032]"

基金资助正文："National Natural Science Foundation of China (82072232 to HYY) ; the Science and Technology Program of Guangzhou, China (202201020028 to HYY) ; the Special Projects in Key Areas of General Colleges and Universities in Guangdong Province (2022ZDZX2003 to HYY) ; the 2021 Annual Medical Teaching and Education Management Reform Research Project of Jinan University (2021YXJG029 to HYY) ; the Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University, China (JNU1AF-CFTP-2022-a01235 to JL) ; and the Science and Technology Projects in Guangzhou, China (202201020054, 2023A03J1032 to JL) ."