Association Between Protocolized Magnesium Supplementation and Atrial Fibrillation or Flutter in Critically Ill Patients: A Multicenter Retrospective Cohort Study
Yarnell CJ, Angriman F, Beaubien E, Brown J, Bruce-Kemevor S, Burry L, Craig J, Donato-Woodger S, Fernando SM, Fowler R, Kattakkayam T, Lamontagne F, Prakash V, Sikaneta T, Sibley S, Soliman K, Tomlinson G, Bodley T
Critical care medicine · 1 cita
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
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 no declarada
Publicación
- Publicado
- 2026-01-30 · Crit Care Med · vol. 54 · número 5 · págs. 1136–1146
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 5 citas · más que el 99% de estudios similares · 21.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 27 trabajos
- Acceso
- De pago
- Áreas de investigación
- Magnesium in Health and Disease · Parathyroid Disorders and Treatments · Magnesium Alloys: Properties and Applications
- Palabras clave
- Critically ill, Atrial fibrillation, Atrial flutter, Retrospective cohort study, Incidence (geometry), Flutter, Cohort study, Cohort
- MeSH
- humans, atrial fibrillation, atrial flutter, critical illness, magnesium, clinical protocols, retrospective studies, dietary supplements, aged, middle aged, intensive care units, ontario, female, male
18 autores
- Christopher J. Yarnell🇨🇦University Health Network; University of Toronto; Scarborough Health Network
- Federico Angriman🇨🇦Sunnybrook Health Science Centre; University of Toronto; Health Sciences Centre
- Eliot R. Beaubien🇨🇦🇬🇧University of Calgary; Peterborough Regional College
- J. Howard Brown🇬🇧🇨🇦Peterborough Regional College; Trent University
- Selasi Bruce-Kemevor🇨🇦Scarborough Health Network
- Lisa Burry🇨🇦University of Toronto
- Joshua Craig🇨🇦University Health Network; Scarborough Health Network
- Simon Donato-Woodger🇨🇦Scarborough Health Network
- Shannon Melania Fernando🇨🇦Queen's University; Lakeridge Health
- Rob Fowler🇨🇦Sunnybrook Health Science Centre; University of Toronto; Health Sciences Centre
- Thecla Kattakkayam🇨🇦Scarborough Health Network
- Francois Lamontagne🇨🇦Université de Sherbrooke; Health and Social Services Centre University Institute of Geriatrics of Sherbrooke
- Varuna Prakash🇨🇦Queen's University; Lakeridge Health
- Tabo Sikaneta🇨🇦University Health Network; Scarborough Health Network
- Stephanie Sibley🇨🇦Lakeridge Health
- Karim Magdy Mohamed Soliman🇨🇦Queen's University; Lakeridge Health
- George Tomlinson🇨🇦University of Toronto
- Thomas F. Bodley🇨🇦University Health Network; University of Toronto; Scarborough Health Network
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objectives
Most ICUs use protocolized magnesium supplementation, yet the clinical effect of this practice is unknown.
Design
Pseudo-randomized retrospective study comparing patients who were and were not assigned to receive magnesium supplementation, using a protocol where supplementation occurs when serum levels are less than or equal to 0.95 mmol/L (2.31 mg/dL). Primary outcome was atrial fibrillation or flutter within 24 hours. Secondary outcomes were tachyarrhythmia (supraventricular tachycardia or ventricular arrhythmia) and death within 24 hours.
Setting
ICUs with a shared magnesium supplementation protocol, in five hospitals in Ontario, Canada, from January 1, 2022, to December 31, 2024.
Patients
Adults (18 yr old or older) admitted to ICU with a magnesium protocol order, at their first magnesium level of 0.92-0.99 mmol/L (2.24-2.41 mg/dL). To minimize confounding, we included only patients with a level near the supplementation threshold.
Interventions
None.
Exposure
Magnesium level 0.92-0.95 mmol/L (2.24-2.31 mg/dL, supplementation group) vs. 0.96-0.99 mmol/L (2.32-2.41 mg/dL, no supplementation group).
Measurements and main results
We identified 4198 patients; median age 70 years, 41% female, 39% invasively ventilated; 2144 (51%) in the supplementation group, of whom 77% received magnesium, and 2054 (49%) in the no supplementation group, of whom 9% received magnesium. Atrial fibrillation or flutter occurred within 24 hours in 355 (16.6%) in the supplementation group and 375 (18.3%) in the no supplementation group. Bayesian logistic regression, adjusted for hospital, showed a 1.6% absolute risk reduction associated with supplementation (95% credible interval, 3.8% reduction to 0.8% increase; probability of reduction, 0.91). For the composite outcome of atrial fibrillation and flutter, tachyarrhythmia, and death, the absolute risk reduction associated with supplementation was 2.2% (CrI, 4.3% reduction to 0.1% increase; probability of risk reduction, 0.97).
Conclusions
Protocolized magnesium supplementation at a threshold of 0.95 mmol/L (2.31 mg/dL) may be associated with reduced 24-hour incidence of atrial fibrillation and flutter in critically ill patients.
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