Djagbletey R, Boni F, Phillips B, Adu-Gyamfi Y, Aniteye E, Owoo C, Owusu-Darkwa E, Yawson A E
Department of Anaesthesia, University of Ghana School of Medicine and Dentistry, College of Health Sciences, P. O. Box 4236, Accra, Ghana.
Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
BMC Anesthesiol. 2015 Oct 6;15:132. doi: 10.1186/s12871-015-0116-7.
Magnesium is the second most abundant intracellular cation and a co-factor in several reactions involved in the formation and usage of adenosine triphosphate and nucleic acid synthesis. Magnesium deficiency may be as high as 65 % in patients admitted to a medical Intensive Care Unit (ICU). Significant and potentially fatal conditions have been attributed to hypomagnesaemia and it has also been associated with poor prognosis and increased mortality in the critically ill. The study aimed to determine the prevalence and identify the predictive factors of preoperative hypomagnesaemia in adult surgical patients who require an emergency laparotomy.
This was a hospital based prospective study conducted at the Korle-Bu teaching hospital. General surgical patients between the ages of eighteen and seventy years with a preoperative diagnosis which required emergency laparotomy for management were consecutively enrolled into the study. A total of 102 patients were enrolled in the study. Preoperative total serum magnesium and serum potassium were determined. Data was summarised utilising simple descriptive statistics (i.e., proportions, ratios and percentages). The Chi-square test was used to determine significant differences or associations between categorical variables, Pearson's correlation coefficient was used to determine the relationship between continuous variables and predictive factors were determined by multiple regression. Analysis was done in SPSS version 16.
The mean serum total magnesium and potassium were 0.66 ± 0.20 mmol/L and 3.79 ± 0.65 mmol/L respectively. The prevalence of preoperative hypomagnesaemia was found to be 68.0 %. Multiple logistic regression found only hypokalaemia to be a predictive factor (p-value of 0.001, odd's ratio of 9.21 and a confidence interval of 2.42-35.09).
The prevalence of preoperative hypomagnesaemia was high (68.0 %) with hypokalaemia the only predictive factor. Hypokalaemic patients requiring emergency laparotomy are nine times more likely to develop hypomagnesaemia as compared to patients who were not hypokalaemic.
镁是细胞内含量第二丰富的阳离子，是三磷酸腺苷形成和利用以及核酸合成过程中多种反应的辅助因子。在入住内科重症监护病房（ICU）的患者中，镁缺乏率可能高达65%。严重且可能致命的病症与低镁血症有关，并且它还与危重症患者的预后不良和死亡率增加相关。该研究旨在确定需要急诊剖腹手术的成年外科患者术前低镁血症的患病率，并识别其预测因素。
这是一项在科勒-布教学医院进行的基于医院的前瞻性研究。年龄在18至70岁之间、术前诊断需要急诊剖腹手术治疗的普通外科患者连续纳入研究。共有102例患者纳入该研究。测定术前血清总镁和血清钾。数据采用简单描述性统计（即比例、比率和百分比）进行汇总。卡方检验用于确定分类变量之间的显著差异或关联，皮尔逊相关系数用于确定连续变量之间的关系，预测因素通过多元回归确定。分析使用SPSS 16版软件进行。
血清总镁和钾的平均值分别为0.66±0.20 mmol/L和3.79±0.65 mmol/L。术前低镁血症的患病率为68.0%。多元逻辑回归发现只有低钾血症是预测因素（p值为0.001，比值比为9.21，置信区间为2.42 - 35.09）。
术前低镁血症的患病率很高（68.0%），低钾血症是唯一的预测因素。与非低钾血症患者相比，需要急诊剖腹手术的低钾血症患者发生低镁血症的可能性高9倍。
