The Department of Geriatric Medicine, Sapir Medical Center, Kfar Saba, Israel.
Arch Gerontol Geriatr. 2010 Jul-Aug;51(1):36-40. doi: 10.1016/j.archger.2009.07.002. Epub 2009 Aug 7.
Electrolyte abnormalities are frequently observed in elderly long-term care (LTC) patients. Magnesium is a trace mineral, but is the second most abundant intracellular cation and the fourth most abundant cation in the body. This was a cross-sectional study to assess the prevalence of hypomagnesemia (HM) in non-selected elderly LTC patients. A total of 159 patients aged 65 years and older were included in the study. The attributes and variables related to the patients' hospital course were used to compare the two groups. We used univariate and multivariate analyses to correlate magnesium levels with demographic, clinical factors and laboratory data. HM was found in 36% of the patients, of whom 35% presented with moderate HM (0.8-0.9 microequiv./l) and 18% with severe HM (<or=0.7 microequiv./l). Patients with HM had a higher number of comorbid diseases per patient (p=0.038), low body mass index (BMI) (p=0.044) and more of them presented with laboratory markers of malnutrition, such as low total cholesterol (TC) and serum albumin (SA) levels. Coexistence with other electrolyte abnormalities was higher among patients with HM than without (p=0.006), predominantly hypocalcemia and hypokalemia (p=0.023 and 0.032, respectively). Using regression analysis, independent variables significantly associated with serum magnesium levels were serum albumin, calcium, potassium, urea levels, chronic renal failure (CRF), chronic heart failure (CHF), diabetes mellitus (DM) and diuretic drugs (R(2)=0.877). Both early (up to 30 days) and late rate of death were higher in patients with HM. The incidence of HM in LTC elderly patients is high and multifactorial. Understanding the causes of HM, correction of magnesium level, and definitive and effective treatment of the cause leading to HM is important to improve patient prognosis.
电解质异常在老年长期护理(LTC)患者中很常见。镁是一种微量元素,但它是细胞内第二丰富的阳离子,也是体内第四丰富的阳离子。这是一项横断面研究,旨在评估非选择性老年 LTC 患者低镁血症(HM)的患病率。共纳入 159 名年龄在 65 岁及以上的患者。研究中使用患者住院期间的属性和变量来比较两组。我们使用单变量和多变量分析将镁水平与人口统计学、临床因素和实验室数据相关联。36%的患者存在 HM,其中 35%为中度 HM(0.8-0.9 μequiv/l),18%为重度 HM(≤0.7 μequiv/l)。HM 患者的每位患者合并症数量更多(p=0.038),体重指数(BMI)较低(p=0.044),且更多患者存在营养不良的实验室标志物,如总胆固醇(TC)和血清白蛋白(SA)水平低。与无 HM 患者相比,HM 患者更常合并其他电解质异常(p=0.006),主要为低钙血症和低钾血症(p=0.023 和 0.032)。使用回归分析,与血清镁水平显著相关的独立变量为血清白蛋白、钙、钾、尿素水平、慢性肾衰竭(CRF)、慢性心力衰竭(CHF)、糖尿病(DM)和利尿剂(R(2)=0.877)。HM 患者的早期(30 天内)和晚期死亡率均较高。LTC 老年患者 HM 的发病率高且多因素。了解 HM 的原因、纠正镁水平以及纠正导致 HM 的根本和有效治疗对改善患者预后很重要。