Donogh Maguire1,2, David P Ross1,2, Dinesh Talwar3, Ewan Forrest4, Hina Naz Abbasi5, John-Paul Leach5,6, Marylynne Woods6, Luke Y Zhu6, Scott Dickson6, Tong Kwok6, Isla Waterson6, George Benson7, Benjamin Scally8, David Young9, Donald C McMillan2. 1. Emergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UK. 2. Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK. 3. The Scottish Trace Elements and Micronutrient Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, UK. 4. Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK. 5. Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK. 6. School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK. 7. Alcohol and Drug Recovery Service, Greater Glasgow and Clyde, Dykebar hospital, Glasgow, UK. 8. Emergency Department, Edinburgh Royal Infirmary, Edinburgh, UK. 9. Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK.
Abstract
BACKGROUND: In 2014, the WHO reported that 6% of all deaths were attributable to excess alcohol consumption. The aim of the present study was to examine the relationship between serum magnesium concentrations and mortality in patients with alcohol withdrawal syndrome (AWS). MATERIALS AND METHODS: A retrospective review of 700 patients with documented evidence of previous AWS indicating a requirement for benzodiazepine prophylaxis or evidence of alcohol withdrawal syndrome between November 2014 and March 2015. RESULTS: Of 380 patients included in the sample analysis, 64 (17%) were dead at 1 year following the time of treatment for AWS. The majority of patients had been prescribed thiamine (77%) and a proton pump inhibitor (66%). In contrast, the majority of patients had low circulating magnesium concentrations (<0.75 mmol/L) (64%) and had not been prescribed magnesium (90%). The median age of death at one year was 55 years (P = 0.002). On univariate analysis, age (P < 0.05), GMAWS (P < 0.05), BDZ (P < 0.05), bilirubin (P < 0.001), alkaline phosphatase (P < 0.001), albumin (P < 0.001), CRP (P < 0.05), AST:ALT ratio >2 (P < 0.001), sodium (P < 0.05), magnesium (P < 0.001), platelets (P < 0.05) and the use of proton pump inhibitor medication (P < 0.001) were associated with death at 1 year. On multivariate binary logistic regression analysis, age > 50 years (OR 3.37, 95% CI 1.52-7.48, P < 0.01), AST:ALT ratio >2 (OR 3.10, 95% CI 1.38-6.94, P < 0.01) and magnesium < 0.75 mmol/L (OR 4.11, 95% CI 1.3-12.8, P < 0.05) remained independently associated with death at 1 year. CONCLUSION: Overall, 1-year mortality was significantly higher among those patients who were magnesium deficient (<0.75 mmol/L) when compared to those who were replete (≥0.75 mmol/L; P < 0.001).
BACKGROUND: In 2014, the WHO reported that 6% of all deaths were attributable to excess alcohol consumption. The aim of the present study was to examine the relationship between serum magnesium concentrations and mortality in patients with alcohol withdrawal syndrome (AWS). MATERIALS AND METHODS: A retrospective review of 700 patients with documented evidence of previous AWS indicating a requirement for benzodiazepine prophylaxis or evidence of alcohol withdrawal syndrome between November 2014 and March 2015. RESULTS: Of 380 patients included in the sample analysis, 64 (17%) were dead at 1 year following the time of treatment for AWS. The majority of patients had been prescribed thiamine (77%) and a proton pump inhibitor (66%). In contrast, the majority of patients had low circulating magnesium concentrations (<0.75 mmol/L) (64%) and had not been prescribed magnesium (90%). The median age of death at one year was 55 years (P = 0.002). On univariate analysis, age (P < 0.05), GMAWS (P < 0.05), BDZ (P < 0.05), bilirubin (P < 0.001), alkaline phosphatase (P < 0.001), albumin (P < 0.001), CRP (P < 0.05), AST:ALT ratio >2 (P < 0.001), sodium (P < 0.05), magnesium (P < 0.001), platelets (P < 0.05) and the use of proton pump inhibitor medication (P < 0.001) were associated with death at 1 year. On multivariate binary logistic regression analysis, age > 50 years (OR 3.37, 95% CI 1.52-7.48, P < 0.01), AST:ALT ratio >2 (OR 3.10, 95% CI 1.38-6.94, P < 0.01) and magnesium < 0.75 mmol/L (OR 4.11, 95% CI 1.3-12.8, P < 0.05) remained independently associated with death at 1 year. CONCLUSION: Overall, 1-year mortality was significantly higher among those patients who were magnesium deficient (<0.75 mmol/L) when compared to those who were replete (≥0.75 mmol/L; P < 0.001).
Authors: Donogh Maguire; Alana Burns; Dinesh Talwar; Anthony Catchpole; Fiona Stefanowicz; David P Ross; Peter Galloway; Alastair Ireland; Gordon Robson; Michael Adamson; Lesley Orr; Joanna-Lee Kerr; Xenofon Roussis; Eoghan Colgan; Ewan Forrest; David Young; Donald C McMillan Journal: Sci Rep Date: 2022-04-28 Impact factor: 4.996
Authors: Flora O Vanoni; Gregorio P Milani; Carlo Agostoni; Giorgio Treglia; Pietro B Faré; Pietro Camozzi; Sebastiano A G Lava; Mario G Bianchetti; Simone Janett Journal: Nutrients Date: 2021-06-07 Impact factor: 5.717
Authors: Donogh Maguire; Dinesh Talwar; Alana Burns; Anthony Catchpole; Fiona Stefanowicz; Gordon Robson; David P Ross; David Young; Alastair Ireland; Ewan Forrest; Peter Galloway; Michael Adamson; Eoghan Colgan; Hannah Bell; Lesley Orr; Joanna-Lee Kerr; Xen Roussis; Donald C McMillan Journal: J Transl Med Date: 2019-11-21 Impact factor: 5.531