ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2015) 38 P30 | DOI: 10.1530/endoabs.38.P30

Audit of management of patients with hypomagnesaemia in district general hospital

K Tofeec1, L Pichaipillai2, T Bani3, A Jostel3 & Y Demssie3

1Salford Royal Foundation Trust, Manchester, UK; 2Christie NHS Foundation Trust, Manchester, UK; 3Royal Blackburn Hospital, Lancashire, UK.

Background: Hypomagnesaemia is one of the most commonly encountered electrolyte disorders in clinical practice. The reported prevalence of hypomagnesaemia varies from 2.5 to 15% in the general population to as high as 65% among patients admitted to intensive care units. There is a general lack of awareness among physicians regarding the prevalence, clinical significance, and management of hypomagnesaemia.

Aim and method: To review current practice of the management of hypomagnesaemia in an inpatient population by conducting retrospective observational study. Fifty-eight patients with moderate to severe hypomagnesaemia were identified, Data was collected from clinical and computer records.

Results: The mean age was 68 years, 18 patients (31%) were males, mean magnesium level on admission was 0.28 mmol/l, 43 patients (74%) had hypocalcaemia with mean calcium level of 1.89 mmol/l. Neuromuscular signs and symptoms were observed in 22 patients (38%). Thirty-seven patients (64%) had two or more risk factors, the PPI was the most common precipitant factor.53 patients (91%) received IV magnesium. PTH, vitamin D, and ECG were checked only in 24, 33, and 59% respectively. Just above 50% have normal magnesium and calcium level on discharge, 46 patients (79%) have modifiable risk factors which have been addressed only in 23 cases (40%). Follow up arranged only for 8 patients (14%). Only 18 patients (31%) have GP notification .13 patients (22%) were readmitted with hypomagnesaemia. Mortality rate was 15% with variable causes of death.

Conclusion and recommendation: In practice, documentation and interpretation of clinical and biochemical findings were poor, due to a combination of the complex, multifactorial aetiology encountered frequently in high risk group, and the lack of a clinically applicable diagnostic algorithm to define the exact cause. An easy to use protocol, to appropriately investigate and manage hypomagnesaemia will need to be introduced and awareness of its existence should be highlighted. This would help in optimising patient’s care.

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