Nayak Raghavendra, Attry Sanjeev, Ghosh Samarendra Nath
Department of Neurosurgery, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
Asian J Neurosurg. 2018 Jul-Sep;13(3):685-688. doi: 10.4103/ajns.AJNS_232_16.
Hypomagnesemia is postulated as one of the important determinants of outcome following traumatic brain injury (TBI) through its effect on secondary injuries to neurons.
The aim of this study was to determine the relationship between serum magnesium level and neurological outcome in patients admitted with severe head injury.
In this prospective study, patients admitted with severe TBI were recruited and dichotomized into low serum magnesium group and normal serum magnesium group based on the initial serum magnesium level. Data were collected regarding age, sex, and Glasgow Coma Scale at admission. Neurological outcome of the patients in these groups was assessed using Glasgow Outcome Scale at 6 months.
Seventy-two patients (male = 50, female = 22) with a mean (±standard deviation) age of 42.5 (±12.7) years were studied. Forty-two (58%) patients had low serum magnesium level (<1.3 mEq/L) at admissions. At 6-month follow-up, 81% of patients with poor neurological outcome had low serum magnesium as compared to 19% of patients with good outcome ( = 0.01). Hypomagnesemia was associated with poor neurological outcome (odds ratio = 2.1, = 0.04, 95% confidence interval = 1.0-8.8) on regression analysis.
Hypomagnesemia appears to be an independent prognostic marker in patients with severe TBI.
低镁血症被认为是创伤性脑损伤(TBI)后预后的重要决定因素之一,因为它会影响神经元的继发性损伤。
本研究旨在确定重度颅脑损伤患者血清镁水平与神经功能预后之间的关系。
在这项前瞻性研究中,招募了因重度TBI入院的患者,并根据初始血清镁水平将其分为低血清镁组和正常血清镁组。收集了患者的年龄、性别以及入院时的格拉斯哥昏迷量表数据。在6个月时使用格拉斯哥预后量表评估这些组患者的神经功能预后。
研究了72例患者(男性50例,女性22例),平均(±标准差)年龄为42.5(±12.7)岁。42例(58%)患者入院时血清镁水平低(<1.3 mEq/L)。在6个月的随访中,神经功能预后差的患者中有81%血清镁水平低,而预后良好的患者中这一比例为19%(P = 0.01)。回归分析显示低镁血症与不良神经功能预后相关(优势比 = 2.1,P = 0.04,95%置信区间 = 1.0 - 8.8)。
低镁血症似乎是重度TBI患者的一个独立预后标志物。