Clinician preference instrumental variable analysis of the effectiveness of magnesium supplementation for atrial fibrillation prophylaxis in critical care
Wilson MG, Rashan A, Klapaukh R, Asselbergs FW, Harris SK
Scientific reports · 8 citas
Cómo se estudió
- Diseño
- Estudio de cohortes (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- Gobierno
- National Institute for Health and Care Research
- Universidad u hospital
- University College London
- Gobierno
- Medical Research Council
- Universidad u hospital
- UCLH Biomedical Research Centre
- Subvenciones
- National Institute for Health and Care Research (MR/N013867/1); Medical Research Council (MR/N013867/1)
Según 5 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2022-10-19 · Sci Rep · vol. 12 · número 1 · pág. 17433
- Editorial
- Nature Portfolio
- Citado
- 9 citas · más que el 67% de estudios similares · 0.8× el promedio de su campo
- Referencias
- 26 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Magnesium in Health and Disease · Cardiac, Anesthesia and Surgical Outcomes · Heart Failure Treatment and Management
- Palabras clave
- Medicine, Atrial fibrillation, Observational study, Stroke (engine), Population, Intensive care medicine, Adverse effect, Emergency medicine, Magnesium deficiency (plants), Internal medicine, Magnesium, Anesthesia
- MeSH
- humans, atrial fibrillation, magnesium, critical care, retrospective studies, dietary supplements, adult
5 autores
- M.G.F. Wilson🇬🇧 · autor de correspondenciaUniversity College London
- Aasiyah Rashan🇬🇧University College London
- Roman Klapaukh🇬🇧University College London
- Folkert Wouter Asselbergs🇳🇱🇬🇧Utrecht University; University Medical Center Utrecht; University College London
- Steve K. Harris🇬🇧University College London Hospitals NHS Foundation Trust; University College London
Resumen
El texto original del estudio, en el idioma en que se publicó.
Atrial fibrillation is a frequently encountered condition in critical illness and causes adverse effects including haemodynamic decompensation, stroke and prolonged hospital stay. It is a common practice in critical care to supplement serum magnesium for the purpose of preventing episodes of atrial fibrillation. However, no randomised studies support this practice in the non-cardiac surgery critical care population, and the effectiveness of magnesium supplementation is unclear. We sought to investigate the effectiveness of magnesium supplementation in preventing the onset of atrial fibrillation in a mixed critical care population. We conducted a single centre retrospective observational study of adult critical care patients. We utilised a natural experiment design, using the supplementation preference of the bedside critical care nurse as an instrumental variable. Using routinely collected electronic patient data, magnesium supplementation opportunities were defined and linked to the bedside nurse. Nurse preference for administering magnesium was obtained using multilevel modelling. The results were used to define "liberal" and "restrictive" supplementation groups, which were inputted into an instrumental variable regression to obtain an estimate of the effect of magnesium supplementation. 9114 magnesium supplementation opportunities were analysed, representing 2137 critical care admissions for 1914 patients. There was significant variation in magnesium supplementation practices attributable to the individual nurse, after accounting for covariates. The instrumental variable analysis showed magnesium supplementation was associated with a 3% decreased relative risk of experiencing an atrial fibrillation event (95% CI - 0.06 to - 0.004, p = 0.03). This study supports the strategy of routine supplementation, but further work is required to identify optimal serum magnesium targets for atrial fibrillation prophylaxis.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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