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急性缺血性卒中患者入院时低镁水平与院内死亡率相关。

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients.

作者信息

You Shoujiang, Zhong Chongke, Du Huaping, Zhang Yu, Zheng Danni, Wang Xia, Qiu Chenhong, Zhao Hongru, Cao Yongjun, Liu Chun-Feng

机构信息

Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Cerebrovasc Dis. 2017;44(1-2):35-42. doi: 10.1159/000471858. Epub 2017 Apr 19.

Abstract

BACKGROUND

Low magnesium levels are associated with an elevated risk of stroke. In this study, we investigated the association between magnesium levels on hospital admission and in-hospital mortality in acute ischemic stroke (AIS) patients.

METHODS

A total of 2,485 AIS patients, enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city, were included in this study. The patients were divided into 4 groups according to their level of admission magnesium: Q1 (<0.82 mmol/L), Q2 (0.82-0.89 mmol/L), Q3 (0.89-0.98 mmol/L), and Q4 (≥0.98 mmol/L). Cox proportional hazard model was used to estimate the effect of magnesium on all-cause in-hospital mortality in AIS patients.

RESULTS

During hospitalization, 92 patients (3.7%) died from all causes. The lowest serum magnesium level (Q1) was associated with a 2.66-fold increase in the risk of in-hospital mortality in comparison to Q4 (hazard ratio [HR] 2.66; 95% CI 1.55-4.56; p-trend < 0.001). After adjusting for age, sex, time from onset to hospital admission, baseline National Institutes of Health Stroke Scale score, and other potential covariates, HR for Q1 was 2.03 (95% CI 1.11-3.70; p-trend = 0.014). Sensitivity and subgroup analyses further confirmed a significant association between lower magnesium levels and a high risk of in-hospital mortality.

CONCLUSIONS

Decreased serum magnesium levels at admission were independently associated with in-hospital mortality in AIS patients.

摘要

背景

低镁水平与中风风险升高相关。在本研究中,我们调查了急性缺血性中风(AIS)患者入院时的镁水平与院内死亡率之间的关联。

方法

本研究纳入了2013年12月至2014年5月期间在苏州市22家医院招募的2485例AIS患者。根据入院时的镁水平将患者分为4组:Q1(<0.82 mmol/L)、Q2(0.82 - 0.89 mmol/L)、Q3(0.89 - 0.98 mmol/L)和Q4(≥0.98 mmol/L)。采用Cox比例风险模型评估镁对AIS患者全因院内死亡率的影响。

结果

住院期间,92例患者(3.7%)死于各种原因。与Q4组相比,最低血清镁水平(Q1)组的院内死亡风险增加了2.66倍(风险比[HR] 2.66;95%可信区间[CI] 1.55 - 4.56;p趋势<0.001)。在调整年龄、性别、发病至入院时间、基线美国国立卫生研究院卒中量表评分和其他潜在协变量后,Q1组的HR为2.03(95% CI 1.11 - 3.70;p趋势 = 0.014)。敏感性分析和亚组分析进一步证实了较低镁水平与高院内死亡风险之间存在显著关联。

结论

入院时血清镁水平降低与AIS患者的院内死亡率独立相关。

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