Reader response: Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.

Abstract

We read with interest the article by Liotta et al.,1 in which lower admission serum magnesium (ASM) was associated with worse outcomes in spontaneous intracerebral hemorrhage (SICH). We reevaluated the prognostic role of ASM in 395 SICH patients in the West China Hospital during 2011 and 2016: 269 male (68.1%), mean age of 57.63 (13.06) years, hematoma volume of 25.599 (25.452) mL, Glasgow Coma Scale (GCS) of 12, and ASM of 2.030 (0.368) mg/dL. With t tests, 91 patients with favorable outcomes had higher ASM levels (2.111 [0.438] vs 2.006 [0.341] mg/dL, p = 0.016); lower ASM levels were found in 97 patients who died within 30 days (2.062 [0.387] vs 1.931 [0.279] mg/dL, p = 0.002). After adjusting for the factors seen in Liotta et al., the GCS (odds ratio [OR] 0.711, 95% confidence interval [CI] 0.652–0.777, p < 0.001), hematoma volume (OR 1.012, 95% CI 1.000–1.025, p = 0.049), hematoma volume change (OR 2.102, 95% CI, 1.637–2.699, p < 0.001), and ASM (OR 0.673, 95% CI, 0.490–0.924, p = 0.015) were associated with 30-day mortality. Moreover, the GCS (OR 0.642, 95% CI 0.554–0.744, p < 0.001) and hematoma volume (OR 1.034, 95% CI 1.013–1.056, p = 0.001) were associated with 3-month outcomes, which kept with previous studies.1–3 However, ASM was not a predictor for 3-month outcomes (OR 0.519, 95% CI 0.099–2.713, p = 0.437). Therefore, our findings add new and important data (i.e., ASM is associated with 30-day mortality) to the literature. However, the association of ASM and 3-month outcomes needs further study.