Dysmagnesemia Measured by Ionized and Total Body Concentrations Among Medically Hospitalized Patients: Incidence, Clinical Characteristics, and Health Outcomes - A Prospective Cohort Study

Dysmagnesemia Measured by Ionized and Total Body Concentrations Among Medically Hospitalized Patients: Incidence, Clinical Characteristics, and Health Outcomes - A Prospective Cohort Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Dysmagnesemia Measured by Ionized and Total Body Concentrations Among Medically Hospitalized Patients: Incidence, Clinical Characteristics, and Health Outcomes - A Prospective Cohort Study Abdullah M. Al Alawi, Zahra Al Shukri, Salim Al Busaidi, Qasim Al-Maamari, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4286385/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Introduction : Ionized Mg (iMg) may offer a more reliable indicator of Mg status during acute illness than total body Mg (tMg) concentrations. This study aimed to determine the incidence of dysmagnesemia and their relationship using iMg and tMg. The clinical and biochemical characteristics as well as health outcomes and their association with iMg and tMg was also assessed. Methods : A prospective study including all eligible adult patients (≥ 18 years) who were hospitalized in the General Internal Medicine unit at Sultan Qaboos University Hospital (SQUH) for 3.5 months in 2023. The iMg and tMg concentrations were collected on all at the admission. Results : In total 500 patients were included (females (49.2%)) with a median age of 64.5 years (IQR: 48–77). The prevalence of hypomagnesemia and hypermagnesemia by iMg concentrations was 3.4% and 26.6%, respectively, while by tMg concentrations 13.2% and 11.0%, respectively. The agreement between both measurements was strong (r = 0.665, p < 0.01). An increased tMg concentration was independently associated high dependency units’ admission (adjusted odds ratio (aOR): 4.34, 95%CI: 1.24–15.06, p = 0.02) and cardiac arrest (aOR: 14.64, 95%CI: 3.04–70.57, p < 0.01), and 6-month all-cause mortality (aOR: 11.44, 95%CI: 2.46–53.17, p < 0.01). During follow-up hypermagnesemia using tMg had a higher mortality compared to other groups (hazard ratio (HR): 1.82, 95%CI: 1.11–3.01, p = 0.02) while no significant findings were demonstrated using iMg concentrations. Conclusion : iMg and tMg concentrations had a strong correlation supporting the use of point-of-care devices for rapid assessment in critical situations. The difference in the associations with health outcomes highlights the importance of further research. Wordcounts: 249 Ionized magnesium total magnesium Hypomagnesemia Hypermagnesemia Hospitalization Mortality Cardiac Arrest Figures Figure 1 Figure 2 Figure 3 Introduction Magnesium (Mg), the fourth most abundant cation in the body, serves as a cofactor for over 300 enzymatic reactions. It facilitates nucleic material and protein synthesis, enables neuromuscular conduction, supports cardiac contractility, aids in energy metabolism, and contributes to immune system function. ( 1 , 2 ) Maintaining a proper Mg balance has been associated with reduced risk of inflammation, diabetes, colorectal cancer, stroke, and cardiovascular events. ( 3 ) Among hospitalized patients, previous research has indicated that hypomagnesemia and hypermagnesemia frequently occur, with prevalence rates ranging from 3.0–29.0% and 5–27%, respectively. ( 3 , 4 , 5 , 6 , 7 , 8 ) Hypomagnesemia is associated with vascular dysfunction, inflammation, and increased risk of arrhythmias.( 9 ) Also, hypomagnesemia in patients with heart failure, critically ill patients, and those undergoing dialysis is linked to higher mortality rates.( 3 ) A meta-analysis indicated that a decrease of 0.49-mg/dL (0.2-mmol/L) in serum Mg concentration was associated with a 30% increase in cardiovascular diseases.( 10 ) Hypermagnesemia can also lead to serious complications such as muscle paralysis, respiratory depression, and cardiac arrest.( 9 ) In a few studies, elevated mortality has been linked to hypermagnesemia, and this may be due to factors such as increased neurohormonal activation, suppressed parathyroid hormone, concurrent kidney dysfunction, and high phosphorus concentrations.( 3 , 8 , 9 , 11 ) Most studies assessing the prevalence, and health outcomes of dysmagnesemia among hospitalized patients used total body Mg (tMg).( 6 , 11 ) However, approximately 99% of Mg in the body is found within the cells, while the remaining Mg in the extracellular space is either bound to albumin, complexed with anions or exists as the bioactive ionized form. Due to this distribution, measuring tMg may not be a reliable indicator of Mg status during acute illness.( 12 ) Moreover, due to its lack of binding to albumin, ionized Mg (iMg) is believed to offer a more precise reflection of Mg concentrations within the body compared to tMg, particularly in critical care scenarios characterized by fluctuating hemodynamics.( 6 , 12 ) An older study suggested a correlation between tMg and iMg concentrations.( 13 ) However, recent observational studies and clinical trials have not found a statistically significant positive correlation between tMg and iMg using Pearson's correlation coefficients (with correlation values ranging from 0.50 to 0.77).( 12 , 14 ) This study aimed to determine the incidence of dysmagnesemia using iMg and tMg concentrations among patients hospitalized in medical wards, as well as their correlation. The associated clinical and biochemical characteristics as well as health outcomes were also assessed. Methods Study Design, Setting, and Population This prospective cohort study was conducted at Sultan Qaboos University Hospital (SQUH) between May 10th and August 31st, 2023. The study included all eligible adult patients (≥ 18 years) who were hospitalized in the General Internal Medicine unit. SQUH is a tertiary hospital with an academic setting, offering comprehensive medical services to inpatients from all regions of Oman.( 15 ) Screening for inclusion was performed for all patients admitted under the care of the General Internal Medicine unit. Exclusion criteria were age younger than 18 years, non-consent, and readmission within 90 days. The iMg and tMg concentrations were collected for all participants once only during the first 24 hrs of admission. Data collection Relevant patient demographic information, including age and sex, was collected, along with medical history including medications with the potential to cause dysmagnesemia, such as loop diuretics, thiazides, and proton pump inhibitors (PPIs). Additionally, specific biochemical data were obtained, including electrolytes as well as measurements of albumin, creatinine, and estimated glomerular filtration rate (eGFR). The treatment of dysmagnesemia and any associated adverse events were carefully recorded. The primary diagnosis of patients was categorized according to the 10th revision of the International Classification of Diseases (ICD-10). Follow-up information was obtained through the review of medical files, and if necessary, by contacting either the patient or their next of kin. Mg measurements The concentration of tMg was determined by performing a colorimetric end-point reaction between Mg and xylidyl blue in an alkaline solution. This analysis was conducted using the Roche Cobas modular analyzer in the Biochemistry Department. Samples of iMg were collected by dedicated research assistants. A 1–2 mL venous whole blood sample was collected from each patient after applying a tourniquet using heparinized syringes containing 60 IU heparin (self-filling sampler by Radiometer®, 2700 Bronshoj, Denmark). The ionized samples were subjected to analysis using the electrolyte analyzer, Stat Profile Prime Plus® (Nova Biomedicals, Waltman, MA, USA). This analyzer utilizes the direct ISE method to determine the concentration of iMg. The method involves a neutral carrier-based membrane containing an ionophore that exhibits selectivity towards the size of the Mg ion. All samples were analyzed in the medical ward by trained research assistants, either immediately or within 1 hour after collection, to ensure the stability of the samples and further details can be found elsewhere.( 12 ) Definitions For iMg concentration measurement: hypomagnesemia was defined based on a local Omani population reference range as an initial iMg concentration of ≤ 0.46 mmol/L, while hypermagnesemia was determined by an iMg concentration of ≥ 0.69 mmol/L.( 12 ) For tMg concentration measurement: hypomagnesemia was defined as a tMg concentration of ≤ 0.69 mmol/L, and hypermagnesemia was defined as a tMg concentration of ≥ 1.01 mmol/L.( 6 ) Sample size The sample size calculation was based on the main outcome, i.e., mortality. A previous study ( 16 ) found 11.7% and 40% in-patient mortality in patients with hypomagnesemia and hypermagnesemia, respectively, compared to only 2.7% death in the normomagnesemia group. In a previous study from the SQUH the incidence of dysmagnesemia was 22.0% ( 6 ), and thus we hypothesized that the excess mortality due to dysmagenesemia would be approximately 8% compared to patients with normomagnesemia. Therefore, using a power of 90% and an alpha level of 5%, a sample size of 456 patients was needed. To account for any missing information and loss of follow-up, the sample size of this study was increased to 500 patients. Ethical Approval Ethical approval was obtained from the Medical and Research Ethics Committee at the College of Medicine and Health Sciences at Sultan Qaboos University (SQU), (MREC #2719; SQU-EC/51/2022) and written informed consent was obtained from the patient or, in case of impaired capacity, next of kin. The study adhered strictly to the ethical guidelines and principles outlined in the Declaration of Helsinki . Statistical analysis Categorical variables were presented as frequencies and percentages. Continuous distributed variables were summarized using median and interquartile ranges (IQRs). Pearson's correlation coefficient and Lin’s concordance correlation coefficients were used to determine the correlation between iMg and tMg concentrations. Bland-Altman plot was used to determine and illustrate the mean differences between iMg and tMg concentrations. The Kruskal-Wallis test determined the relationship between variables and different iMg concentration groups. The Chi-Square test was performed to examine the relationships between categorical variables and different Mg concentration groups, while Fisher's exact test was applied if the cells had an anticipated frequency of less than five. The correlation between albumin concentrations and iMg and tMg concentrations was assessed using a Spearman's rho test and illustrated using a scatter plot. All relevant characteristics were included in the backward stepwise regression analysis to identify potential independent factors associated with each group of dysmagnesemia using an adjusted odds ratio (aOR). Lastly, time-to-event survival analysis for 90-day re-admission and 6-month all-cause mortality was performed using the Kaplan–Meier method, and log-rank tests for comparisons among patients in the three different groups of iMg concentration to indignity Hazard ration (HR). The two-tailed level of significance was set at p<0.05 level. Statistical analyses were conducted using STATA version 17.0 (STATA Corporation, College Station, TX, USA). Results In total 500 patients were included, 246 (49.2%) were female. The median age was 64.5 years (IQR: 48-77). Most of the patients had a history of hypertension (n=330, 66.0%) and diabetes mellitus (DM) (n=262, 52.4%). Other prevalent medical comorbidities included chronic kidney disease (CKD) (n=122, 24.4%), heart failure (n=103, 20.6%), and atrial fibrillation (AF) (n=103, 20.6%). The commonly prescribed medications included PPIs (n=389, 77.8%), followed by loop diuretics (n=193, 38.6%), and thiazides (n=51, 10.2%). The prevalence of hypomagnesemia measured by iMg concentration was 3.4% (95% CI 2.1% - 5.4%), while the prevalence of hypermagnesemia measured by iMg concentration was 26.6% (95% CI 22.9% - 30.7%). The prevalence of hypomagnesemia measured by tMg concentration was 13.2% (95% CI 10.5% - 16.5%), and the prevalence of hypermagnesemia measured by tMg concentration was 11.0% (95% CI 8.5% - 14.1%). The agreement between iMg and tMg concentrations was examined using a Bland-Altman Plot, demonstrating a Pearson's correlation coefficient (r) of 0.665 ( p < 0.01). This indicates a strong positive correlation. The negative correlation between difference and mean (-0.458), with a Bradley Blackwood F value of 959.964 ( p < 0.01), further supports the relationship between iMg and tMg. The prevalence of DM was higher in the hypomagnesemia group measured by iMg concentration compared to normomagnesemia and hypermagnesemia groups (82.4% vs. 54.9% vs. 42.1%; p < 0.01) but there were no differences between the groups by tMg ( Table 1 and Table 2 ). Conversely, CKD was more common in the hypermagnesemia group measured by iMg concentration compared to normomagnesemia and hypomagnesemia groups (33.8% vs. 20.8% vs. 23.5%; p = 0.01), and a similar association was found among the groups measured by tMg concentrations. The hypomagnesemia group measured by iMg concentration had significantly higher sodium concentrations compared to the normomagnesemia and hypermagnesemia groups (138 vs. 136 vs. 137 mmol/L; p = 0.04). Conversely, the hypermagnesemia group measured by iMg concentration had significantly higher serum creatinine concentrations compared to the normomagnesemia and hypomagnesemia groups (92 vs. 78 vs. 72 mmol/L; p < 0.01) ( Table 1 ). In terms of medications, loop diuretics were more commonly used in patients with hypermagnesemia by tMg concentration (54.6% vs. 38.5% vs. 25.8%; p <0.01) ( Table 2 ). There were no other significant differences in the characteristics, clinical features, and laboratory profiles of the patients when they were classified based on iMg and tMg concentrations ( Table 1 and Table 2 ). During hospitalization, 20.8% of patients (n = 104) received some form of Mg replacement. Among the hypomagnesemia group measured by iMg concentration, 58.8% (n = 10) of patients received Mg replacement, which is almost the same as patients treated for hypomagnesemia measured by tMg concentration (56.0%; n = 37) ( Table 1 and Table 2 ). As shown in Figure 1 , the correlation between albumin concentrations and iMg and tMg concentrations was assessed using a Spearman's rho test. The results revealed a non-significant weak positive correlation (Spearman's rho = 0.075, p = 0.09) between albumin concentrations and iMg. In contrast, there was a significant weak positive correlation between albumin concentrations and tMg concentrations (Spearman's rho = 0.088, p = 0.04). Regarding clinical outcomes, there were no significant differences observed among the different groups of iMg concentrations ( Table 3 ). However, the hypermagnesemia group measured by tMg concentration exhibited higher rates of high dependency units’ admission (HDU) (38.2% vs. 21.4% vs. 21.2%; p =0.02), cardiac arrest (20.00% vs. 7.70% vs. 9.10%; p =0.01) and increased 6-month all-cause mortality (9.1%20.0% vs. 11.6% vs. 23.6%; p =0.03) compared to the normomagnesemia and hypermagnesemia groups ( Table 4 ). Table 5 shows the calculated fraction of iMg to tMg. The results demonstrated a significant association with adverse outcomes (including, high dependency admission, cardiac arrest, inpatient mortality, and 6-month mortality) when the fraction fell below 60%, in other words, a difference of 40% or more between iMg and tMg concentrations. Further, we calculated the positive predictive value (PPV) to examine the link between mortality and hypomagnesemia by tMg, and it was 9.1% while hypomagnesemia by iMg value was 17.9%. Moreover, the PPV between mortality and hypermagnesemia by tMg was 23.6% while hypermagnesemia by tMg value was 15.0%. Multivariate regression analysis reinforced the association and identified the tMg as an independent predictor associated with these adverse clinical outcomes, including; high dependency units’ admission (aOR: 4.34, 95% CI: 1.24 - 15.06, p =0.02), cardiac arrest (aOR: 14.64, 95% CI: 3.04 - 70.57, p <0.01), and 6-month all-cause mortality (aOR: 11.44, 95% CI: 2.46 - 53.17, p <0.01) ( Table 6 ). Survival analysis was conducted using both iMg and tMg. No significant difference was found between the groups regarding the first readmission within 90 days ( Figure 2 ). However, in terms of all-cause mortality at 6 months, survival analysis using iMg did not reveal any significant difference ( Figure 3-A) , but the analysis using tMg indicated increased mortality in the hypermagnesemia group compared to the normomagnesemia and hypermagnesemia groups (HR: 1.87, 95% CI: 1.11 - 3.01, p =0.02) ( Figure 3-B) . Discussion The study is the first study that provides data using both iMg and tMg to assess the prevalence of dysmagnesemia and associated health outcomes among hospitalized patients in medical wards. A strong agreement between iMg and tMg concentrations was found. Hypomagnesemia measured by iMg concentration was associated with a higher prevalence of diabetes, while hypermagnesemia by both iMg and tMg correlated with CKD. Also, the increase in tMg concentrations showed an independent association with adverse health outcomes. The biologically active fraction of circulating Mg is iMg. While iMg could potentially serve as a more physiologically relevant marker compared to tMg, previous studies have suggested that both concentrations might not correlate very well during hospitalization.(17, 18) There is a lack of agreement regarding the precise range of serum tMg concentrations deemed sufficient, resulting in varying suggested intervals for both research and clinical purposes. Regarding iMg, intervals of 0.53–0.67 mmol/L and 0.44–0.59 mmol/L have predominantly been utilized, while for tMg, ranges of 0.75–0.95 mmol/L, 0.70–1.00 mmol/L, and 0.70–1.10 mmol/L have commonly been used.(19) A strong positive correlation (Pearson's correlation) between iMg and tMg concentrations was found. The iMg samples were analyzed using fresh blood within 1 hour by trained research assistants in the medical ward, which may account for the observed positive correlation. These findings support to the utilization of point-of-care analyzers for assessing iMg status in hospitalized patients, particularly when timely clinical decisions are necessary to guide patient management, including cases involving cardiac arrhythmia.(20) In the present study, significant discrepancies were observed in the prevalence of dysmagnesemia when comparing the use of iMg and tMg concentrations. Which is in concordance with previous studies.(17, 21, 22) These differences could be attributed to variations in defining the normal Mg concentration for iMg and tMg. For example, in our setting, the reference range for iMg was established using fresh samples obtained from healthy volunteers specifically from the Omani population.(12) Furthermore, tMg concentrations could be underestimated in acutely ill medical patients due to low albumin concentrations, which is also the case in this study.(23) Despite iMg being the active form of Mg, there have been very few studies assessing iMg concentrations among hospitalized patients.(13) One study found that the prevalence of hypomagnesemia defined as iMg concentrations less than 0.48 mmol/L, was 12.7% in patients presenting to the emergency department with de novo AF.(20) Another study including 31 patients following abdominal surgery, found that both tMg and iMg concentrations decreased during surgery, with a strong correlation between both.(13) Overall, hypermagnesemia is increasingly recognized as an issue among hospitalized patients. Several factors have contributed to the reported increase in hypermagnesemia cases, including increased awareness of the harmful effects of hypomagnesemia, leading to widespread use of Mg treatment in hospitalized patients and as a supplement in individuals with chronic diseases, particularly cardiovascular conditions.(3) Additionally, the global rise in CKD may contribute to higher apparent Mg concentrations due to reduced renal excretion.(24) DM was highly prevalent among the hypomagnesemia group measured by iMg concentrations, which could be attributed to the increased excretion of Mg in urine due to glucosuria, nutritional deficiencies, and the development of hypomagnesemia induced by hyperinsulinemia. Hypomagnesemia is linked to an accelerated and enduring decline in renal function among patients with DM.(25) Furthermore, epidemiological investigations consistently reveal a negative correlation between the intake of Mg through the diet and the risk of developing T2DM.(25, 26) On the other hand, patients with hypermagnesemia by both iMg and tMg concentrations had a higher prevalence of CKD, elevated serum creatinine concentrations, and eGFR. (27) The rate of magnesium replacement was higher in both hypomagnesemia groups measured by iMg and tMg compared to other groups, which aligns with findings from a prior RCT which showed that the administered amount of Mg oxide replacement, guided by both iMg and tMg measurements, was similar and had no discernible impact on the development of arrhythmia. (28) However, there remains insufficient evidence supporting the use of iMg as a guiding factor in treatment decisions, particularly regarding its impact on the increment concentration and subsequent clinical outcomes. We believe that an RCT is needed to look into this hypothesis. (18) Nevertheless, it is crucial to note that in our setting, the replacement was not guided by iMg concentrations but rather by tMg concentrations and we have not looked into other subsequent concentrations post-replacement. Evaluating Mg status is intricately complex since only less than 1% of the total body magnesium is present in both serum and red blood cells, with the majority residing intracellularly. The serum Mg, constituting approximately 0.3% of the total body Mg, exists in three states: 62% as iMg, 33% bound to proteins, primarily albumin, and the remaining 5% forming complexes with anions.(29, 30) Given the complex nature of Mg metabolism, multiple associations were examined to explore the connections between various forms of Mg and other biochemical parameters. Our study revealed a weakly positive association between albumin and both tMg and iMg concentrations. However, the statistical significance was observed only with tMg concentrations. These findings align with a systematic review and meta-analysis investigating Mg metabolism in individuals with chronic alcohol use disorder. A substantial reduction in both tMg and iMg among these patients was reported, but it did not identify a direct association with albumin.(31) Dysmagnesemia is associated with poor health outcomes as demonstrated in previous studies among hospitalized patients.(3, 11) The current study showed that hypermagnesemia measured by tMg concentration was an independent factor associated with an increased need for high dependency admission, an elevated rate of cardiopulmonary arrest and poor survival. In a large study involving 65,974 patients, hypermagnesemia by tMg was associated with prolonged length of hospital stay and increased hospital mortality.(3) Another study concluded that total hypermagnesemia was associated with increased mortality among patients who were admitted with acute decompensation of heart failure.(32) In another study involving 20,438 participants, it was found that hypomagnesemia and hypermagnesemia measured by tMg were associated with increased in-hospital mortality. Particularly, the risk was higher in patients with hypermagnesemia.(16, 33) Moreover, among patients admitted with community-acquired pneumonia, both hypomagnesemia and hypermagnesemia measured by tMg at admission were associated with an increased rate of 30-day mortality.(34) Limited research has investigated the relationship between dysmagnesmia by iMg and health outcomes among hospitalized patients. Furthermore, most of the existing studies have focused on critically ill patients admitted to ICU.(22) A study that included 144 ICU patients showed that hypermagnesemia by iMg was associated with mortality.(22) Another study, consisting of 446 patients, found that the development of hypomagnesemia by iMg during an ICU stay was associated with a poor prognosis which is often associated with the use of diuretics and sepsis.(35) We further investigated this complex relation between different measurements of iMg and tMg concentrations and the associated outcomes by calculating the fraction of iMg to tMg. We identified an association with adverse clinical outcomes when the difference between both measurements exceeded 40%. A study found an association between the iMg/tMg fraction when exceeding 72% and an elevated APACHE II score surpassing 20 in the ICU setting. They also found that this increased score was associated with an increased in-hospital mortality risk of 40%, with a PPV exceeding 53%.(21) Furthermore, the elevated iMg/tMg fraction exhibited a negative correlation with albumin concentrations and we know that low albumin concentrations are associated with increased mortality risk. (21, 36) Additionally, in this study, the iMg/tMg fraction was predominantly associated with a significant decrease in iMg and concurrently inappropriately normal tMg concentrations when the difference between the two exceeded 40%. This observation may contribute to a more comprehensive understanding of the stronger association with adverse clinical outcomes when compared to tMg or iMg in isolation. Notably, our findings revealed a higher PPV for hypomagnesemia by iMg with 6-month mortality (17.6%) compared to hypomagnesemia measured by tMg (9.1%). This is in concordance with the literature and supports the fact that hypomagnesemia measured by iMg is associated with unfavorable clinical outcomes, including mortality.(19, 35) Besides that, the inverse correlation between serum albumin concentrations and iMg/tMg fraction can be explained by positing that individuals with lower albumin concentrations tend to have a higher proportion of their serum Mg in the ionized form.(37) This was described as “pseudo-hypomagnesemia” of tMg concentration as a result of hypoalbuminemia with normal serum iMg concentrations.(38) In general, there is a dearth of comprehensive research on the significance of dysmagnesemia by iMg, especially among patients hospitalized in general medical wards. The absence of prior studies primarily focused on this specific population emphasizes the necessity for further investigation in this field. This study has several strengths, including the prospective design and the inclusion of both tMg and iMg measurements. The study findings raise questions about the potential confounding effect behind the previously reported association between total dysmagnesemia and poor health outcomes. Limitations of the study include that it is a single-center study, measurements of magnesium concentration were done only once for each patient without further in-hospital or discharge follow-up measures and our reference range used for both iMg and tMg may not be adequate. Conclusion The study demonstrated a strong positive correlation between concentrations of iMg and tMg, supporting the potential use of point-of-care devices for rapid assessment of iMg in critical situations. Notably, hypomagnesemia by iMg was associated with a higher prevalence of diabetes, while hypermagnesemia by both iMg and tMg showed associations with CKD. Dysmagnesemia by iMg did not show an association with poor health outcomes, however, multivariant regression analysis showed that hypermagnesemia by tMg was linked with adverse health outcomes. These findings highlight the importance of further research to examine the complex associations and impacts of dysmagnesemia in various clinical settings. Declarations Data availability All necessary data are included, and further data are available on reasonable request to the corresponding author. Conflict of interest All authors declared no conflict of interest. The manuscript content has not been published or submitted for publication elsewhere. All the authors reviewed the manuscript and intellectually contributed to the manuscript. Funding The research was supported by a grant from the Ministry of Higher Education, Research, and Innovation (MOHERI), BFP/GRG/HSS/22/077. Nova Biomedical (Waltman, Massachusetts, United States) supplied the electrolytes analyzer for ionized magnesium detection with its consumables (Stat Profile Prime Plus®). Technical support and maintenance services were provided by Nova Biomedical and Global Source Trading. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit. Institutional Review Board Statement The study was approved by the Medical and Research Ethics Committee at the College of Medicine and Health Sciences, SQU, Muscat, Oman (MREC #2719; SQU-EC/51/2022; dated: April 1 st , 2022). Author contributions Conceptualization: AA and HF: Data curation: ZS, DA, QM, MT, AS and RB: Formal analysis: JM: Funding acquisition: AA, and SB: Investigation: AA, JM, ZS and SB: Methodology: AA, JM and ZS: Project administration: AA and JM: Resources: AA, JM, ZS and SB: Machine handling: QM, MT and DA. Supervision: AA and JM. Validation: AA and JM: Drafting the manuscript: AA, SB, HF and JM. Critical review of the manuscript for important intellectual content: All authors. References Al Alawi AM, Al Badi A, Al Huraizi A, Falhammar H. Magnesium: The recent research and developments. Adv Food Nutr Res. 2021;96:193-218. Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018;2018:9041694. Cheungpasitporn W, Thongprayoon C, Qian Q. Dysmagnesemia in Hospitalized Patients: Prevalence and Prognostic Importance. Mayo Clin Proc. 2015;90(8):1001-10. 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Escuela MP, Guerra M, Añón JM, Martínez-Vizcaíno V, Zapatero MD, García-Jalón A, et al. Total and ionized serum magnesium in critically ill patients. Intensive Care Med. 2005;31(1):151-6. Hansen BA, Bruserud Ø. Hypomagnesemia in critically ill patients. J Intensive Care. 2018;6:21. Cockwell P, Fisher LA. The global burden of chronic kidney disease. Lancet. 2020;395(10225):662-4. Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? Diabetes. 2016;65(1):3-13. Pham PC, Pham PM, Pham PA, Pham SV, Pham HV, Miller JM, et al. Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2. Clin Nephrol. 2005;63(6):429-36. Galán Carrillo I, Vega A, Goicoechea M, Shabaka A, Gatius S, Abad S, et al. Impact of Serum Magnesium Levels on Kidney and Cardiovascular Prognosis and Mortality in CKD Patients. J Ren Nutr. 2021;31(5):494-502. Steinberger HA, Hanson CW, 3rd. Outcome-based justification for implementing new point-of-care tests: there is no difference between magnesium replacement based on ionized magnesium and total magnesium as a predictor of development of arrhythmias in the postoperative cardiac surgical patient. Clin Lab Manage Rev. 1998;12(2):87-90. Fawcett WJ, Haxby EJ, Male DA. Magnesium: physiology and pharmacology. Br J Anaesth. 1999;83(2):302-20. Ray BS. Louise Eisenhardt. 1891-1967. Surg Neurol. 1977;8(4):227-8. Vanoni FO, Milani GP, Agostoni C, Treglia G, Fare PB, Camozzi P, et al. Magnesium Metabolism in Chronic Alcohol-Use Disorder: Meta-Analysis and Systematic Review. Nutrients. 2021;13(6). Cidade-Rodrigues C, Cunha FM, Elias C, Carreira M, Barroso I, Bettencourt P, et al. The prognostic impact of magnesium in acute heart failure is different according to the presence of diabetes mellitus. Porto Biomed J. 2022;7(6):e197. Angkananard T, Anothaisintawee T, Eursiriwan S, Gorelik O, McEvoy M, Attia J, et al. The association of serum magnesium and mortality outcomes in heart failure patients: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(50):e5406. Nasser R, Naffaa ME, Mashiach T, Azzam ZS, Braun E. The association between serum magnesium levels and community-acquired pneumonia 30-day mortality. BMC Infect Dis. 2018;18(1):698. Soliman HM, Mercan D, Lobo SS, Melot C, Vincent JL. Development of ionized hypomagnesemia is associated with higher mortality rates. Crit Care Med. 2003;31(4):1082-7. McCluskey A, Thomas AN, Bowles BJ, Kishen R. The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit. Anaesthesia. 1996;51(8):724-7. Saha H, Harmoinen A, Karvonen AL, Mustonen J, Pasternack A. Serum ionized versus total magnesium in patients with intestinal or liver disease. Clin Chem Lab Med. 1998;36(9):715-8. Kulpmann WR, Rossler J, Brunkhorst R, Schuler A. Ionised and total magnesium serum concentrations in renal and hepatic diseases. Eur J Clin Chem Clin Biochem. 1996;34(3):257-64. Tables Table 1 : Characteristics, clinical features, and laboratory profiles of the admitted patients categorized according to ionized Mg concentrations. Characteristic n (%) unless specified otherwise Total 500 (100%) ≤ 0.46 mmol/L 17 (3.4%) 0.47-0.68 mmol/L 350 (70.0%) ≥ 0.69 mmol/L 133 (26.6%) p -value Female sex 246 (49.2%) 10 (58.8%) 175 (50.0%) 61 (45.9%) 0.52 Age; IQR, years 64.5 (48 – 77) 69 (59 – 75) 64.5 (48 – 77) 64 (48 – 78) 0.88 BMI; IQR, kg/m 2 25.81 (23.35 – 29.55) 26.26 (25.40 – 29.03) 25.99 (23.63 – 29.73) 25.71 (22.57 – 28.97) 0.42 Medical History Hypertension 330 (66.0%) 13 (76.47%) 232 (66.3%) 85 (63.9%) 0.58 Diabetes Mellitus 262 (52.4%) 14 (82.4%) 192 (54.9%) 56 (42.1%) <0.01 Chronic Kidney Disease 122 (24.4%) 4 (23.5%) 73 (20.9%) 45 (33.8%) 0.01 ESRD (dialysis) 19 (3.80%) 0 13 (3.7%) 6 (4.5%) 0.65 Heart Failure 103 (20.6%) 5 (29.4%) 71 (20.3%) 27 (20.3%) 0.66 Irritable bowel syndrome 1 (0.2%) 0 1 (0.3%) 0 1.00 Autoimmune Disease 8 (1.6%) 0 6 (1.7%) 2 (1.5%) 1.00 Refeeding Syndrome 2 (0.4%) 0 1 (0.3%) 1 (0.8%) 0.51 Celiac Disease 3 (0.6%) 0 3 (0.9%) 0 0.61 Bariatric Surgery 1 (0.2%) 0 1 (0.3%) 0 1.00 Alcohol consumption 48 (9.6%) 1 (5.9%) 33 (9.4%) 14 (10.5%) 0.81 Smoking 35 (7.0%) 2 (11.8%) 25 (7.1%) 8 (6.0%) 0.67 IVDU 10 (2.0%) 0 5 (1.4%) 5 (3.8%) 0.22 Medications Loop diuretics 193 (38.6%) 7 (41.2%) 129 (36.9%) 57 (42.9%) 0.47 Thiazides 51 (10.2%) 1 (5.9%) 42 (12.0%) 8 (6.0%) 0.12 Proton pump inhibitors 389 (77.8%) 13 (76.5%) 279 (79.7%) 97 (72.8%) 0.28 Gentamicin 4 (0.8%) 1 (5.9%) 3 (0.86%) 0 0.08 Amikacin 22 (4.4%) 2 (22.7%) 16 (4.6%) 4 (3.0%) 0.20 Paromomycin 1 (0.2%) 0 0 1 (0.8%) 0.30 Amphotericin B 5 (1.0%) 0 2 (0.6%) 3 (2.7%) 0.27 Tacrolimus 4 (0.8%) 0 3 (0.9%) 1 (0.8%) 1.00 Cyclosporine 1 (0.2%) 0 0 1 (0.8%) 0.30 Primary diagnosis according to ICD10 Infectious disease (A00-B99) 66 (13.2%) 2 (11.8%) 48 (13.7%) 16 (12.0%) 0.93 Endocrine, nutritional, and metabolic diseases (E00-E99) 38 (7.6%) 1 (5.9%) 30 (8.6%) 7 (5.3%) 0.45 Diseases of the nervous system (G03-G72) 25 (5.0%) 0 16 (4.6%) 9 (6.8%) 0.49 Diseases of the circulatory system (I16-I99) 117 (23.4%) 7 (41.2%) 83 (23.7%) 27 (20.3%) 0.16 Diseases of the respiratory system (J00-J99) 79 (15.8%) 2 (11.76%) 56 (16.0%) 21 (12.8%) 1.00 Diseases of the digestive system (K00-K93) 39 (7.8%) 0 30 (8.6%) 9 (6.8%) 0.52 Diseases of the genitourinary system (N00-N99) 45 (9.0%) 1 (5.9%) 30 (8.6%) 14 (10.5%) 0.75 Others 91 (18.2%) 4 (23.5%) 57 (16.3%) 30 (22.6%) 0.22 Electrolytes (serum or plasma) Albumin, IQR, mmol/L 38 (34 – 43) 36 (36 – 40) 38 (34 – 43) 39 (35 – 43) 0.49 Corrected Calcium, IQR, mmol/L 2.30 (2.24 – 2.38) 2.30 (2.18 – 2.39) 2.30 (2.23 – 2.38) 2.30 (2.21 – 2.37) 0.21 Sodium, IQR, mmol/L 136 (133 – 139) 138 (135 – 139) 136 (133 – 138) 137 (133 – 139) 0.04 Potassium, IQR, mmol/L 4.3 (3.9 – 4.7) 4.3 (4.0 – 4.6) 4.3 (3.9 – 4.7) 4.3 (4.0 – 4.6) 0.72 Chloride, IQR, mmol/L 101 (97 – 104) 100 (98 – 104) 101 (97 – 104) 102 (98 – 104) 0.26 Creatinine, IQR, mmol/L 80 (58 – 127) 74 (55 – 78) 78 (57 – 111) 92 (63 – 184) < 0.01 eGFR, IQR, ml/min/1.73 m 2 80 (90 – 42) 90 (69 – 90) 83 (51 – 90) 60 (31 – 90) < 0.01 Hypomagnesemia Treatment (Mg replacement) Mg replacement 104 (20.8%) 10 (58.8%) 76 (21.7%) 18 (13.5%) < 0.01 IV Mg 99 (19.8%) 10 (58.8%) 72 (20.6%) 17 (12.9%) < 0.01 Oral Mg 5 (1.0%) 0 4 (1.1%) 1 (0.8%) 0.85 Total dose of Mg replacement; IQR, gram 0 2 (0 – 6) 0 0 < 0.01 BMI; Body Mass Index, ESRD; End Stage Renal Disease, and IVDU; Intravenous Drug User. Table 2 : Characteristics, clinical features, and laboratory profiles of the admitted patients categorized according to total Mg concentrations. Characteristic n (%) unless specified otherwise Total 500 (100%) ≤ 0.69 mmol/L 66 (13.2%) 0.70-1.00 mmol/L 379 (75.8%) ≥ 1.01 mmol/L 55 (11.0%) p -value Female sex 246 (49.2%) 38 (57.6%) 184 (48.6%) 24 (43.6%) 0.27 Age; IQR, years 64.5 (48 – 77) 61.5 (46 – 75) 65 (48 – 77) 66 (47 – 80) 0.65 BMI; IQR, kg/m 2 25.81 (23.35 – 29.55) 26.97 (23.87 – 29.90) 26.00 (23.72 – 29.73) 25.40 (20.80 – 27.88) 0.06 Medical History Hypertension 330 (66.0%) 45 (68.2%) 246 (64.9%) 39 (70.9%) 0.63 Diabetes Mellitus 262 (52.4%) 42 (63.6%) 193 (50.9%) 27 (49.1%) 0.14 Chronic Kidney Disease 122 (24.4%) 11 (16.7%) 87 (23.0%) 24 (43.6%) <0.01 ESRD (dialysis) 19 (3.8%) 1 (1.5%) 12 (3.2%) 6 (10.9%) 0.02 Heart Failure 103 (20.6%) 12 (18.2%) 75 (19.8%) 16 (20.1%) 0.25 Irritable bowel syndrome 1 (0.2%) 0 1 (0.3%) 0 1.00 Autoimmune Disease 8 (1.6%) 2 (3.0%) 6 (1.6%) 0 0.46 Refeeding Syndrome 2 (0.4%) 0 2 (0.5%) 1 (0.8%) 0.51 Celiac Disease 3 (0.6%) 0 3 (0.8%) 0 1.00 Bariatric Surgery 1 (0.2%) 1 (1.5%) 0 0 0.24 Alcohol consumption 48 (9.6%) 7 (10.6%) 34 (9.0%) 7 (12.7%) 0.54 Smoking 35 (7.0%) 6 (9.1%) 24 (6.3%) 5 (9.1%) 0.58 IVDU 10 (2.0%) 1 (1.5%) 8 (2.11%) 1 (1.8%) 0.95 Medications Loop diuretics 193 (38.6%) 17 (25.8%) 146 (38.5%) 30 (54.6%) <0.01 Thiazides 51 (10.2%) 5 (7.6%) 42 (11.1%) 4 (7.3%) 0.51 Proton pump inhibitors 389 (77.8%) 51 (77.3%) 294 (77.6%) 44 (80.0%) 0.92 Gentamicin 4 (0.8%) 0 4 (1.1%) 0 1.00 Amikacin 22 (4.4%) 4 (6.1%) 17 (4.5%) 1 (1.8%) 0.61 Paromomycin 1 (0.2%) 0 1 (0.3%) 0 0.30 Amphotericin B 5 (1.0%) 1 (1.5%) 3 (0.8%) 1 (1.8%) 0.35 Tacrolimus 4 (0.8%) 0 4 (1.1%) 0 1.00 Cyclosporine 1 (0.2%) 0 0 1 (1.2%) 0.11 Primary diagnosis according to ICD10 Infectious disease (A00-B99) 66 (13.2%) 14 (21.2%) 45 (11.9%) 7 (12.7%) 0.12 Endocrine, nutritional, and metabolic diseases (E00-E99) 38 (7.6%) 6 (9.1%) 25 (6.6%) 7 (12.7%) 0.25 Diseases of the nervous system (G03-G72) 25 (5.0%) 3 (4.6%) 17 (4.5%) 5 (9.1%) 0.33 Diseases of the circulatory system (I16-I99) 117 (23.4%) 12 (18.2%) 98 (25.9%) 7 (12.7%) 0.05 Diseases of the respiratory system (J00-J99) 79 (15.8%) 2 (3.0%) 71 (18.7%) 6 (10.9%) < 0.01 Diseases of the digestive system (K00-K93) 39 (7.8%) 9 (13.64%) 24 (6.3%) 6 (10.9%) 0.08 Diseases of the genitourinary system (N00-N99) 45 (9.0%) 7 (10.6%) 31 (8.2%) 7 (12.4%) 0.48 Others 91 (18.2%) 13 (19.7%) 68 (17.9%) 10 (18.2%) 0.94 Electrolytes (serum or plasma) Albumin, IQR, mmol/L 38 (34 – 43) 36 (33 – 41) 39 (34 – 43) 38 (35 – 42) 0.03 Corrected Calcium, IQR, mmol/L 2.30 (2.24 – 2.38) 2.30 (2.20 – 2.41) 2.30 (2.23 – 2.37) 2.29 (2.21 – 2.37) 0.94 Sodium, IQR, mmol/L 136 (133 – 139) 136 (132 – 139) 136 (133 – 138) 136 (133 – 140) 0.78 Potassium, IQR, mmol/L 4.3 (3.9 – 4.7) 4.2 (3.9 – 4.4) 4.3 (3.9 – 4.7) 4.8 (4.1 – 5.4) < 0.01 Chloride, IQR, mmol/L 101 (97 - 104) 101 (98 – 105) 101 (97 – 104) 101 (97 – 104) 0.62 Creatinine, IQR, mmol/L 80 (58 – 127) 72 (53 – 99) 78 (56 – 111) 189 (92 – 337) < 0.01 eGFR, IQR, ml/min/1.73 m 2 80 (90 – 42) 89 (57 – 90) 83 (52 – 90) 29 (14 – 55) < 0.01 Hypomagnesemia Treatment (Mg replacement) Mg replacement 104 (20.8%) 37 (56.0%) 59 (15.6%) 8 (14.6%) < 0.01 IV Mg 99 (19.8%) 34 (51.5%) 75 (13.0%) 8 (14.6%) < 0.01 Oral Mg 5 (1.0%) 3 (4.6%) 2 (0.5%) 0 < 0.01 Total dose of Mg replacement; IQR, gram 0 2 (0 – 4) 0 0 < 0.01 BMI; Body Mass Index, ESRD; End Stage Renal Disease, and IVDU; Intravenous Drug User. Table 3 : Patient clinical outcomes classified according to ionized Mg concentrations. Characteristic n (%) unless specified otherwise Total 500 (100%) ≤ 0.46 mmol/L 17 (3.4%) 0.47-0.68 mmol/L 350 (70.0%) ≥ 0.69 mmol/L 133 (26.6%) p -value Length of stay, IQR, (Days) 4.54 (2.53 – 9.26) 4.7 (3.41 – 9.79) 4.54 (2.47 – 8.71) 4.51 (2.67 – 10.21) 0.60 High Dependency Unit 116 (23.2%) 5 (29.4%) 76 (21.7%) 35 (26.3%) 0.46 Development of Ventricular Fibrillation after admission 3 (0.6%) 0 2 (0.57%) 1 (0.8%) 1.00 Development of Ventricular Tachycardia after admission 6 (1.2%) 0 4 (1.14%) 2 (1.2%) 0.73 Development of Atrial Fibrillation after admission 56 (11.2%) 4 (23.53%) 34 (9.71%) 18 (13.5%) 0.10 Cardiac arrest 46 (9.2%) 2 (11.8%) 29 (8.3%) 15 (11.3%) 0.56 Inpatient mortality 36 (7.2%) 0 25 (7.1%) 11 (8.3%) 0.46 90-day readmission 82 (16.4%) 2 (11.8%) 60 (17.1%) 20 (15.0%) 0.74 6-month all-cause mortality 63 (12.6%) 3 (17.7%) 40 (11.4%) 20 (15.0%) 0.46 Table 4 : Patient clinical outcomes classified according to total Mg concentrations. Characteristic n (%) unless specified otherwise Total 500 (100%) ≤ 0.69 mmol/L 66 (13.2%) 0.70-1.00 mmol/L 379 (75.8%) ≥ 1.01 mmol/L 55 (11.0%) p -value Length of stay, IQR, (Days) 4.47 (2.52 – 9.03) 5.33 (3.46 – 10.33) 4.35 (2.41 – 8.70) 4.51 (2.92 – 10.89) 0.12 High Dependency Unit 116 (23.2%) 14 (21.2%) 81 (21.4%) 21 (38.2%) 0.02 Development of Ventricular Fibrillation after admission 3 (0.6%) 0 3 (0.8%) 0 1.00 Development of Ventricular Tachycardia after admission 6 (1.0%) 2 (1.06%) 4 (1.1%) 0 0.30 Development of Atrial Fibrillation (AF) after admission 56 (11.2%) 7 (10.6%) 41 (10.8%) 8 (14.6%) 0.69 Cardiac arrest 46 (9.2%) 6 (9.1%) 29 (7.7%) 11 (20.0%) 0.01 Inpatient mortality 36 (7.2%) 4 (6.1%) 26 (6.9%) 6 (10.9%) 0.51 90-day readmission 82 (16.4%) 11 (16.7%) 58 (15.3%) 13 (23.6%) 0.29 6-month all-cause mortality 63 (12.6%) 6 (9.09%) 44 (11.6%) 13 (23.6%) 0.03 Table 5 : Patient clinical outcomes classified according to fraction (iMg/tMg) concentration. Characteristic n (%) unless specified otherwise Total 500 (100%) ≤ 60% 19 (3.8%) 61-80% 335 (67.0%) ≥ 81% 146 (29.2%) p -value Length of stay, IQR, (Days) 4.47 (2.52 – 9.03) 3.24 (1.77 – 6.40) 4.50 (2.54 – 8.75) 4.57 (2.66 – 10.20) 0.22 High Dependency Unit 116 (23.2%) 11 (57.9%) 70 (20.9%) 35 (24.0%) <0.01 Development of Ventricular Fibrillation after admission 3 (0.6%) 0 2 (0.6%) 1 (0.7%) 0.94 Development of Ventricular Tachycardia after admission 6 (1.2%) 0 3 (0.9%) 3 (2.1%) 0.49 Development of Atrial Fibrillation (AF) after admission 56 (11.2%) 2 (10.5%) 41 (12.2%) 13 (8.9%) 0.56 Cardiac arrest 46 (9.2%) 7 (36.8%) 29 (8.7%) 10 (6.9%) <0.01 Inpatient mortality 36 (7.2%) 7 (36.8%) 15 (5.4%) 11 (7.5%) <0.01 90-day readmission 82 (16.4%) 3 (15.8%) 58 (17.3%) 21 (14.4%) 0.73 6-month all-cause mortality 63 (12.6%) 9 (47.4%) 41 (12.2%) 13 (8.9 %) <0.01 Table 6 : Multivariate logistic regression for independent factors associated with total Mg concentrations and clinical outcomes (HDU, cardiac arrest and 6-month mortality). Outcome tested in the model Independent factors aOR* [95% CI] p -value High Dependency Unit Total Mg concentration 4.34 [1.24 - 15.06] 0.02 Frusemide 3.09 [1.99 - 4.79] <0.01 Cardiac arrest Total Mg concentration 14.64 [3.04 - 70.57] <0.01 Female 0.48 [0.24 - 0.95] 0.04 Albumin mmol/L 0.93 [0.88 – 0.96] <0.01 Frusemide 3.29 [1.61 - 6.72] <0.01 6-month mortality Total Mg concentration 11.44 [2.46 - 53.17] <0.01 Albumin mmol/L 0.89 [0.85 – 0.93] <0.01 Frusemide 1.91 [1.04 - 3.51] 0.04 Age 1.03 [1.01 - 1.05] <0.01 *Backward stepwise multi -regression model for an adjusted odds ratio (aOR) for the following relevant factors that includes total Mg concentrations , age, female, body mass index, diabetes, hypertension, chronic kidney disease, heart failure, potassium, sodium, creatinine, estimated glomerular filtration rate, albumin, frusemide, and Mg correction/treatment. Additional Declarations No competing interests reported. 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Hospital","correspondingAuthor":false,"prefix":"","firstName":"Dawood","middleName":"Al","lastName":"Amri","suffix":""},{"id":293035163,"identity":"7f7afff1-7005-409f-a940-b69071e5e08c","order_by":8,"name":"Henrik Falhammar","email":"","orcid":"","institution":"Karolinska University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Henrik","middleName":"","lastName":"Falhammar","suffix":""},{"id":293035167,"identity":"351cbe8b-2ab0-42c9-bd75-cd39bfe78afd","order_by":9,"name":"Juhaina Salim Al-Maqbali","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAt0lEQVRIiWNgGAWjYBACxgYgkcBjA2I2HiBeywOZNDCTOC1gbQ9sDoMZxGlh7j+duiEh57zd2vbDQFtqbKIJ2zAjd9uNhDO3k7edSQRqOZaW20BYC++2G4k9t5PNDgC1MDYcJkJL/1mgln/nks3OPyRWSwPIYTwH7MxuEG0L2C88yQlmN4C2JBDjF0Ogw27+4LGzNzuf/vDBhxobIrRAVSSC6QRCykFAHkrbE6N4FIyCUTAKRigAABf/Tdj9zyfHAAAAAElFTkSuQmCC","orcid":"","institution":"Sultan Qaboos University Hospital","correspondingAuthor":true,"prefix":"","firstName":"Juhaina","middleName":"Salim","lastName":"Al-Maqbali","suffix":""}],"badges":[],"createdAt":"2024-04-18 08:50:46","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4286385/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4286385/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55511122,"identity":"51bbfc05-e2c6-4f50-b30c-c99278ea0c0a","added_by":"auto","created_at":"2024-04-29 12:33:41","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51477,"visible":true,"origin":"","legend":"\u003cp\u003eEffect of albumin concentrations on \u003cem\u003eionized \u003c/em\u003eMg\u003cem\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/em\u003eand \u003cem\u003etotal\u003c/em\u003eMg concentrations (N = 500).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4286385/v1/83c03be2340fbc42c4ee4c43.png"},{"id":55512052,"identity":"364ec61a-45ff-4764-ac25-eed10ebdbf21","added_by":"auto","created_at":"2024-04-29 12:41:41","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":29398,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan Meier analysis for 90-days readmission stratified according to \u003cem\u003eionized \u003c/em\u003eMg and \u003cem\u003etotal\u003c/em\u003e Mg concentrations for all survived patients (N = 500).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4286385/v1/1de26bcacea26f80ee2d090d.png"},{"id":55511120,"identity":"b59d5ca9-2b22-4652-956c-d14c826efaa5","added_by":"auto","created_at":"2024-04-29 12:33:41","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":26019,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan Meier analysis for the first 6-month all-cause mortality stratified according to \u003cem\u003eionized \u003c/em\u003eMg and \u003cem\u003etotal\u003c/em\u003e Mg concentrations for all survived patients (N = 500).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4286385/v1/c5eee4c52cdffd95a62d533b.png"},{"id":55512743,"identity":"921986b7-593c-4ecc-8742-ae9be14bb48d","added_by":"auto","created_at":"2024-04-29 12:49:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":615217,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4286385/v1/d921d822-6bcf-4e40-90eb-11d72bbb742b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Dysmagnesemia Measured by Ionized and Total Body Concentrations Among Medically Hospitalized Patients: Incidence, Clinical Characteristics, and Health Outcomes - A Prospective Cohort Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMagnesium (Mg), the fourth most abundant cation in the body, serves as a cofactor for over 300 enzymatic reactions. It facilitates nucleic material and protein synthesis, enables neuromuscular conduction, supports cardiac contractility, aids in energy metabolism, and contributes to immune system function. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) Maintaining a proper Mg balance has been associated with reduced risk of inflammation, diabetes, colorectal cancer, stroke, and cardiovascular events. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) Among hospitalized patients, previous research has indicated that hypomagnesemia and hypermagnesemia frequently occur, with prevalence rates ranging from 3.0\u0026ndash;29.0% and 5\u0026ndash;27%, respectively. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eHypomagnesemia is associated with vascular dysfunction, inflammation, and increased risk of arrhythmias.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) Also, hypomagnesemia in patients with heart failure, critically ill patients, and those undergoing dialysis is linked to higher mortality rates.(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) A meta-analysis indicated that a decrease of 0.49-mg/dL (0.2-mmol/L) in serum Mg concentration was associated with a 30% increase in cardiovascular diseases.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eHypermagnesemia can also lead to serious complications such as muscle paralysis, respiratory depression, and cardiac arrest.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) In a few studies, elevated mortality has been linked to hypermagnesemia, and this may be due to factors such as increased neurohormonal activation, suppressed parathyroid hormone, concurrent kidney dysfunction, and high phosphorus concentrations.(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eMost studies assessing the prevalence, and health outcomes of dysmagnesemia among hospitalized patients used total body Mg (tMg).(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) However, approximately 99% of Mg in the body is found within the cells, while the remaining Mg in the extracellular space is either bound to albumin, complexed with anions or exists as the bioactive ionized form. Due to this distribution, measuring tMg may not be a reliable indicator of Mg status during acute illness.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) Moreover, due to its lack of binding to albumin, ionized Mg (iMg) is believed to offer a more precise reflection of Mg concentrations within the body compared to tMg, particularly in critical care scenarios characterized by fluctuating hemodynamics.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) An older study suggested a correlation between tMg and iMg concentrations.(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) However, recent observational studies and clinical trials have not found a statistically significant positive correlation between tMg and iMg using Pearson's correlation coefficients (with correlation values ranging from 0.50 to 0.77).(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThis study aimed to determine the incidence of dysmagnesemia using iMg and tMg concentrations among patients hospitalized in medical wards, as well as their correlation. The associated clinical and biochemical characteristics as well as health outcomes were also assessed.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design, Setting, and Population\u003c/h2\u003e \u003cp\u003eThis prospective cohort study was conducted at Sultan Qaboos University Hospital (SQUH) between May 10th and August 31st, 2023. The study included all eligible adult patients (\u0026ge;\u0026thinsp;18 years) who were hospitalized in the General Internal Medicine unit. SQUH is a tertiary hospital with an academic setting, offering comprehensive medical services to inpatients from all regions of Oman.(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) Screening for inclusion was performed for all patients admitted under the care of the General Internal Medicine unit. Exclusion criteria were age younger than 18 years, non-consent, and readmission within 90 days. The iMg and tMg concentrations were collected for all participants once only during the first 24 hrs of admission.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eRelevant patient demographic information, including age and sex, was collected, along with medical history including medications with the potential to cause dysmagnesemia, such as loop diuretics, thiazides, and proton pump inhibitors (PPIs). Additionally, specific biochemical data were obtained, including electrolytes as well as measurements of albumin, creatinine, and estimated glomerular filtration rate (eGFR). The treatment of dysmagnesemia and any associated adverse events were carefully recorded. The primary diagnosis of patients was categorized according to the 10th revision of the International Classification of Diseases (ICD-10). Follow-up information was obtained through the review of medical files, and if necessary, by contacting either the patient or their next of kin.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eMg measurements\u003c/h2\u003e \u003cp\u003eThe concentration of tMg was determined by performing a colorimetric end-point reaction between Mg and xylidyl blue in an alkaline solution. This analysis was conducted using the Roche Cobas modular analyzer in the Biochemistry Department.\u003c/p\u003e \u003cp\u003eSamples of iMg were collected by dedicated research assistants. A 1\u0026ndash;2 mL venous whole blood sample was collected from each patient after applying a tourniquet using heparinized syringes containing 60 IU heparin (self-filling sampler by Radiometer\u0026reg;, 2700 Bronshoj, Denmark). The ionized samples were subjected to analysis using the electrolyte analyzer, Stat Profile Prime Plus\u0026reg; (Nova Biomedicals, Waltman, MA, USA). This analyzer utilizes the direct ISE method to determine the concentration of iMg. The method involves a neutral carrier-based membrane containing an ionophore that exhibits selectivity towards the size of the Mg ion. All samples were analyzed in the medical ward by trained research assistants, either immediately or within 1 hour after collection, to ensure the stability of the samples and further details can be found elsewhere.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eDefinitions\u003c/h2\u003e \u003cp\u003eFor iMg concentration measurement: hypomagnesemia was defined based on a local Omani population reference range as an initial iMg concentration of \u0026le;\u0026thinsp;0.46 mmol/L, while hypermagnesemia was determined by an iMg concentration of \u0026ge;\u0026thinsp;0.69 mmol/L.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eFor tMg concentration measurement: hypomagnesemia was defined as a tMg concentration of \u0026le;\u0026thinsp;0.69 mmol/L, and hypermagnesemia was defined as a tMg concentration of \u0026ge;\u0026thinsp;1.01 mmol/L.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eSample size\u003c/h2\u003e \u003cp\u003eThe sample size calculation was based on the main outcome, i.e., mortality. A previous study (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) found 11.7% and 40% in-patient mortality in patients with hypomagnesemia and hypermagnesemia, respectively, compared to only 2.7% death in the normomagnesemia group. In a previous study from the SQUH the incidence of dysmagnesemia was 22.0% (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), and thus we hypothesized that the excess mortality due to dysmagenesemia would be approximately 8% compared to patients with normomagnesemia. Therefore, using a power of 90% and an alpha level of 5%, a sample size of 456 patients was needed. To account for any missing information and loss of follow-up, the sample size of this study was increased to 500 patients.\u003c/p\u003e \u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthical Approval\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Medical and Research Ethics Committee at the College of Medicine and Health Sciences at Sultan Qaboos University (SQU), (MREC #2719; SQU-EC/51/2022) and written informed consent was obtained from the patient or, in case of impaired capacity, next of kin. The study adhered strictly to the ethical guidelines and principles outlined in the Declaration of Helsinki\u003cem\u003e.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eStatistical analysis\u003c/em\u003e\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCategorical variables were presented as frequencies and percentages. Continuous distributed variables were summarized using median and interquartile ranges (IQRs). Pearson\u0026apos;s correlation coefficient and Lin\u0026rsquo;s concordance correlation coefficients were used to determine the correlation between iMg and tMg concentrations. Bland-Altman plot was used to determine and illustrate the mean differences between iMg and tMg concentrations. The Kruskal-Wallis test determined the relationship between variables and different iMg concentration groups. The Chi-Square test was performed to examine the relationships between categorical variables and different Mg concentration groups, while Fisher\u0026apos;s exact test was applied if the cells had an anticipated frequency of less than five. The correlation between albumin concentrations and iMg and tMg concentrations was assessed using a Spearman\u0026apos;s rho test and illustrated using a scatter plot. All relevant characteristics were included in the backward stepwise regression analysis to identify potential independent factors associated with each group of dysmagnesemia using an adjusted odds ratio (aOR). Lastly, time-to-event survival analysis for 90-day re-admission and 6-month all-cause mortality was performed using the Kaplan\u0026ndash;Meier method, and log-rank tests for comparisons among patients in the three different groups of iMg concentration to indignity Hazard ration (HR). The two-tailed level of significance was set at p\u0026lt;0.05 level. Statistical analyses were conducted using STATA version 17.0 (STATA Corporation, College Station, TX, USA).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn total 500 patients were included, 246 (49.2%) were female. The median age was 64.5 years (IQR: 48-77). Most of the patients had a history of hypertension (n=330, 66.0%) and diabetes mellitus (DM) (n=262, 52.4%). Other prevalent medical comorbidities included chronic kidney disease (CKD) (n=122, 24.4%), heart failure (n=103, 20.6%), and atrial fibrillation (AF) (n=103, 20.6%). The commonly prescribed medications included PPIs (n=389, 77.8%), followed by loop diuretics (n=193, 38.6%), and thiazides (n=51, 10.2%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe prevalence of hypomagnesemia measured by iMg concentration was 3.4% (95% CI 2.1% - 5.4%), while the prevalence of hypermagnesemia measured by iMg concentration was 26.6% (95% CI 22.9% - 30.7%). The prevalence of hypomagnesemia measured by tMg concentration was 13.2% (95% CI 10.5% - 16.5%), and the prevalence of hypermagnesemia measured by tMg concentration was 11.0% (95% CI 8.5% - 14.1%). \u0026nbsp;The agreement between iMg and tMg concentrations was examined using a Bland-Altman Plot, demonstrating a Pearson\u0026apos;s correlation coefficient (r) of 0.665 (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01). This indicates a strong positive correlation. The negative correlation between difference and mean\u0026nbsp;(-0.458), with a Bradley Blackwood F value of 959.964 (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01), further supports the relationship between iMg and tMg.\u003c/p\u003e\n\u003cp\u003eThe prevalence of DM was higher in the hypomagnesemia group\u0026nbsp;measured by iMg concentration\u0026nbsp;compared to normomagnesemia and hypermagnesemia groups (82.4% \u003cem\u003evs.\u003c/em\u003e 54.9% \u003cem\u003evs.\u003c/em\u003e 42.1%; \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01) but there were no differences between the groups by tMg (\u003cstrong\u003eTable 1 and Table 2\u003c/strong\u003e). Conversely, CKD was more common in the hypermagnesemia group\u0026nbsp;measured by iMg concentration\u0026nbsp;compared to normomagnesemia and hypomagnesemia groups (33.8% \u003cem\u003evs.\u003c/em\u003e 20.8% \u003cem\u003evs.\u003c/em\u003e 23.5%; \u003cem\u003ep\u003c/em\u003e = 0.01), and a similar association was found among the groups measured by tMg\u0026nbsp;concentrations. The hypomagnesemia group\u0026nbsp;measured by iMg concentration\u0026nbsp;had significantly higher sodium concentrations compared to the normomagnesemia and hypermagnesemia groups (138 \u003cem\u003evs.\u003c/em\u003e 136 \u003cem\u003evs.\u003c/em\u003e 137 mmol/L; \u003cem\u003ep\u003c/em\u003e = 0.04). Conversely, the hypermagnesemia group\u0026nbsp;measured by iMg concentration\u0026nbsp;had significantly higher serum creatinine concentrations compared to the normomagnesemia and hypomagnesemia groups (92 \u003cem\u003evs.\u003c/em\u003e 78 vs. 72 mmol/L; \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01) (\u003cstrong\u003eTable 1\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003eIn terms of medications, loop diuretics were more commonly used in patients with hypermagnesemia\u0026nbsp;by tMg concentration\u0026nbsp;(54.6% \u003cem\u003evs.\u003c/em\u003e 38.5% \u003cem\u003evs.\u003c/em\u003e 25.8%; \u003cem\u003ep\u003c/em\u003e \u0026lt;0.01) (\u003cstrong\u003eTable 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere were no other significant differences in the characteristics, clinical features, and laboratory profiles of the patients when they were classified based on iMg and tMg concentrations (\u003cstrong\u003eTable 1 and Table 2\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003eDuring hospitalization, 20.8% of patients (n = 104) received some form of Mg replacement. Among the hypomagnesemia group\u0026nbsp;measured by iMg concentration, 58.8% (n = 10) of patients received Mg replacement, which is almost the same as patients treated for hypomagnesemia\u0026nbsp;measured by tMg concentration\u0026nbsp;(56.0%; n = 37) (\u003cstrong\u003eTable 1 and Table 2\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003eAs shown in \u003cstrong\u003eFigure 1\u003c/strong\u003e, the correlation between albumin concentrations and iMg and tMg concentrations was assessed using a Spearman\u0026apos;s rho test. The results revealed a non-significant weak positive correlation (Spearman\u0026apos;s rho = 0.075, \u003cem\u003ep\u003c/em\u003e = 0.09) between albumin concentrations and iMg. In contrast, there was a significant weak positive correlation between albumin concentrations and tMg concentrations (Spearman\u0026apos;s rho = 0.088, \u003cem\u003ep\u003c/em\u003e = 0.04).\u003c/p\u003e\n\u003cp\u003eRegarding clinical outcomes, there were no significant differences observed among the different groups of iMg concentrations (\u003cstrong\u003eTable 3\u003c/strong\u003e). However, the hypermagnesemia group\u0026nbsp;measured by tMg concentration\u0026nbsp;exhibited higher rates of high dependency units\u0026rsquo; admission (HDU) (38.2% \u003cem\u003evs.\u003c/em\u003e 21.4% \u003cem\u003evs.\u003c/em\u003e 21.2%; \u003cem\u003ep\u003c/em\u003e =0.02), cardiac arrest (20.00% \u003cem\u003evs.\u003c/em\u003e 7.70% \u003cem\u003evs.\u003c/em\u003e 9.10%; \u003cem\u003ep\u0026nbsp;\u003c/em\u003e=0.01) and increased 6-month all-cause mortality (9.1%20.0% \u003cem\u003evs.\u003c/em\u003e 11.6% \u003cem\u003evs.\u003c/em\u003e 23.6%; \u003cem\u003ep\u003c/em\u003e =0.03) compared to the normomagnesemia and hypermagnesemia groups (\u003cstrong\u003eTable 4\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e shows the calculated fraction of iMg to tMg. The results demonstrated a significant association with adverse outcomes (including, high dependency admission, cardiac arrest, inpatient mortality, and 6-month mortality) when the fraction fell below 60%, in other words, a difference of 40% or more between iMg and tMg concentrations. Further, we calculated the positive predictive value (PPV) to examine the link between mortality and hypomagnesemia by tMg, and it was 9.1% while hypomagnesemia by iMg value was 17.9%. Moreover, the PPV between mortality and hypermagnesemia by tMg was 23.6% while hypermagnesemia by tMg value was 15.0%.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMultivariate regression analysis reinforced the association and identified the tMg as an independent predictor associated with these adverse clinical outcomes, including; high dependency units\u0026rsquo; admission (aOR: 4.34, 95% CI:\u0026nbsp;1.24 - 15.06, \u003cem\u003ep\u003c/em\u003e =0.02), cardiac arrest (aOR: 14.64, 95% CI:\u0026nbsp;3.04 - 70.57,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt;0.01), and 6-month all-cause mortality (aOR: 11.44, 95% CI:\u0026nbsp;2.46 - 53.17,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt;0.01) (\u003cstrong\u003eTable 6\u003c/strong\u003e). Survival analysis was conducted using both iMg and tMg. No significant difference was found between the groups regarding the first readmission within 90 days (\u003cstrong\u003eFigure 2\u003c/strong\u003e). However, in terms of all-cause mortality at 6 months, survival analysis using iMg did not reveal any significant difference (\u003cstrong\u003eFigure 3-A)\u003c/strong\u003e, but the analysis using tMg indicated increased mortality in the hypermagnesemia group compared to the normomagnesemia and hypermagnesemia groups (HR: 1.87, 95% CI:\u0026nbsp;1.11 - 3.01, \u003cem\u003ep\u0026nbsp;\u003c/em\u003e=0.02) (\u003cstrong\u003eFigure 3-B)\u003c/strong\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study is the first study that provides data using both iMg and tMg to assess the prevalence of dysmagnesemia and associated health outcomes among hospitalized patients in medical wards. A strong agreement between iMg and tMg concentrations was found. Hypomagnesemia\u0026nbsp;measured by iMg concentration\u0026nbsp;was associated with a higher prevalence of diabetes, while hypermagnesemia\u0026nbsp;by both iMg and tMg\u0026nbsp;correlated with CKD. Also, the increase in tMg concentrations showed an independent association with\u0026nbsp;adverse health outcomes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe biologically active fraction of circulating Mg is iMg. While iMg could potentially serve as a more physiologically relevant marker compared to tMg, previous studies have suggested that both concentrations might not correlate very well during hospitalization.(17, 18)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is a lack of agreement regarding the precise range of serum tMg concentrations deemed sufficient, resulting in varying suggested intervals for both research and clinical purposes. Regarding iMg, intervals of 0.53\u0026ndash;0.67 mmol/L and 0.44\u0026ndash;0.59 mmol/L have predominantly been utilized, while for tMg, ranges of 0.75\u0026ndash;0.95 mmol/L, 0.70\u0026ndash;1.00 mmol/L, and 0.70\u0026ndash;1.10 mmol/L have commonly been used.(19)\u003c/p\u003e\n\u003cp\u003eA strong positive correlation (Pearson\u0026apos;s correlation) between iMg and tMg concentrations was found. The iMg samples were analyzed using fresh blood within 1 hour by trained research assistants in the medical ward, which may account for the observed positive correlation. These findings support to the utilization of point-of-care analyzers for assessing iMg status in hospitalized patients, particularly when timely clinical decisions are necessary to guide patient management, including cases involving cardiac arrhythmia.(20)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the present study, significant discrepancies were observed in the prevalence of dysmagnesemia when comparing the use of iMg and tMg concentrations. Which is in concordance with previous studies.(17, 21, 22)\u0026nbsp;These differences could be attributed to variations in defining the normal Mg\u0026nbsp;concentration\u0026nbsp;for iMg and tMg. For example, in our setting, the reference range for iMg was established using fresh samples obtained from healthy volunteers specifically from the Omani population.(12)\u0026nbsp;Furthermore, tMg concentrations could be underestimated in acutely ill medical patients due to low albumin concentrations, which is also the case in this study.(23)\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDespite iMg being the active form of Mg, there have been very few studies assessing iMg concentrations among hospitalized patients.(13)\u0026nbsp;One study found that the prevalence of hypomagnesemia defined as iMg concentrations less than 0.48 mmol/L, was 12.7% in patients presenting to the emergency department with de novo AF.(20)\u0026nbsp; Another study including 31 patients following abdominal surgery, found that both tMg and iMg concentrations decreased during surgery, with a strong correlation between both.(13)\u003c/p\u003e\n\u003cp\u003eOverall, hypermagnesemia is increasingly recognized as an issue among hospitalized patients. Several factors have contributed to the reported increase in hypermagnesemia cases, \u0026nbsp;including increased awareness of the harmful effects of hypomagnesemia, leading to widespread use of Mg treatment in hospitalized patients and as a supplement in individuals with chronic diseases, particularly cardiovascular conditions.(3)\u0026nbsp;Additionally, the global rise in CKD may contribute to higher apparent Mg concentrations due to reduced renal excretion.(24)\u003c/p\u003e\n\u003cp\u003eDM was highly prevalent among the hypomagnesemia group measured by iMg concentrations, which could be attributed to the increased excretion of Mg in urine due to glucosuria, nutritional deficiencies, and the development of hypomagnesemia induced by hyperinsulinemia. Hypomagnesemia is linked to an accelerated and enduring decline in renal function among patients with DM.(25)\u0026nbsp;Furthermore, epidemiological investigations consistently reveal a negative correlation between the intake of Mg through the diet and the risk of developing T2DM.(25, 26)\u0026nbsp;On the other hand, patients with hypermagnesemia by both iMg and tMg concentrations had a higher prevalence of CKD, elevated serum creatinine concentrations, and eGFR.\u0026nbsp;(27)\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe rate of magnesium replacement was higher in both\u0026nbsp;hypomagnesemia groups measured by iMg and tMg compared to other groups, which\u0026nbsp;aligns with findings from a prior RCT which showed that the administered amount of Mg oxide replacement, guided by both\u0026nbsp;iMg and tMg\u0026nbsp;measurements, was similar and had no discernible impact on the development of arrhythmia.\u0026nbsp;(28)\u0026nbsp;However, there remains insufficient evidence supporting the use of iMg as a guiding factor in treatment decisions, particularly regarding its impact on the increment concentration and subsequent clinical outcomes. We believe that an RCT is needed to look into this hypothesis.\u0026nbsp;(18)\u0026nbsp;Nevertheless, it is crucial to note that in our setting, the replacement was not guided by iMg concentrations but rather by tMg concentrations and we have not looked into other subsequent concentrations post-replacement.\u003c/p\u003e\n\u003cp\u003eEvaluating Mg status is intricately complex since only less than 1% of the total body magnesium is present in both serum and red blood cells, with the majority residing intracellularly. The serum Mg, constituting approximately 0.3% of the total body Mg, exists in three states: 62% as iMg, 33% bound to proteins, primarily albumin, and the remaining 5% forming complexes with anions.(29, 30)\u0026nbsp;Given the complex nature of Mg metabolism, multiple associations were examined to explore the connections between various forms of Mg and other biochemical parameters. Our study revealed a weakly positive association between albumin and both tMg and iMg concentrations. However, the statistical significance was observed only with tMg concentrations. These findings align with a systematic review and meta-analysis investigating Mg metabolism in individuals with chronic alcohol use disorder. A substantial reduction in both tMg and iMg among these patients was reported, but it did not identify a direct association with albumin.(31)\u003c/p\u003e\n\u003cp\u003eDysmagnesemia is associated with poor health outcomes as demonstrated in previous studies among hospitalized patients.(3, 11)\u0026nbsp;The current study showed that hypermagnesemia measured by tMg concentration was an independent factor associated with an increased need for high dependency admission, an elevated rate of cardiopulmonary arrest and poor survival. In a large study involving 65,974 patients, hypermagnesemia by tMg was associated with prolonged length of hospital stay and increased hospital mortality.(3)\u0026nbsp;Another study concluded that total hypermagnesemia was associated with increased mortality among patients who were admitted with acute decompensation of heart failure.(32)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn another study involving 20,438 participants, it was found that hypomagnesemia and hypermagnesemia measured by tMg were associated with increased in-hospital mortality. Particularly, the risk was higher in patients with hypermagnesemia.(16, 33)\u0026nbsp;Moreover, among patients admitted with community-acquired pneumonia, both hypomagnesemia and hypermagnesemia measured by tMg at admission were associated with an increased rate of 30-day mortality.(34)\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLimited research has investigated the relationship between dysmagnesmia by iMg and health outcomes among hospitalized patients. Furthermore, most of the existing studies have focused on critically ill patients admitted to ICU.(22)\u0026nbsp;A study that included 144 ICU patients showed that hypermagnesemia by iMg was associated with mortality.(22)\u0026nbsp;Another study, consisting of 446 patients, found that the development of hypomagnesemia by iMg during an ICU stay was associated with a poor prognosis which is often associated with the use of diuretics and sepsis.(35)\u003c/p\u003e\n\u003cp\u003eWe further investigated this complex relation between different measurements of iMg and tMg concentrations and the associated outcomes by calculating the fraction of iMg to tMg. We identified an association with adverse clinical outcomes when the difference between both measurements exceeded 40%. A study found an association between the iMg/tMg fraction when exceeding 72% and an elevated APACHE II score surpassing 20 in the ICU setting. They also found that this increased score was associated with an increased in-hospital mortality risk of 40%, with a PPV exceeding 53%.(21)\u0026nbsp;Furthermore, the elevated iMg/tMg fraction exhibited a negative correlation with albumin concentrations and we know that low albumin concentrations are associated with increased mortality risk.\u0026nbsp;(21, 36)\u003c/p\u003e\n\u003cp\u003eAdditionally, in this study, the iMg/tMg fraction was predominantly associated with a significant decrease in iMg and concurrently inappropriately normal tMg concentrations when the difference between the two exceeded 40%. This observation may contribute to a more comprehensive understanding of the stronger association with adverse clinical outcomes when compared to tMg or iMg in isolation. Notably, our findings revealed a higher PPV for hypomagnesemia\u0026nbsp;by iMg\u0026nbsp;with 6-month mortality (17.6%) compared to hypomagnesemia measured by tMg (9.1%). This is in concordance with the literature and supports the fact that hypomagnesemia measured by iMg is associated with unfavorable clinical outcomes, including mortality.(19, 35)\u0026nbsp;Besides that, the inverse correlation between serum albumin concentrations and iMg/tMg fraction can be explained by positing that individuals with lower albumin concentrations tend to have a higher proportion of their serum Mg in the ionized form.(37)\u0026nbsp;This was described as \u0026ldquo;pseudo-hypomagnesemia\u0026rdquo; of tMg concentration as a result of hypoalbuminemia with normal serum iMg concentrations.(38)\u003c/p\u003e\n\u003cp\u003eIn general, there is a dearth of comprehensive research on the significance of dysmagnesemia by iMg, especially among patients hospitalized in general medical wards. The absence of prior studies primarily focused on this specific population emphasizes the necessity for further investigation in this field.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study has several strengths, including the prospective design and the inclusion of both tMg and iMg measurements. The study findings raise questions about the potential confounding effect behind the previously reported association between total dysmagnesemia and poor health outcomes. Limitations of the study include that it is a single-center study, measurements of magnesium concentration were done only once for each patient without further in-hospital or discharge follow-up measures and our reference range used for both iMg and tMg may not be adequate.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study demonstrated a strong positive correlation between concentrations of iMg and tMg, supporting the potential use of point-of-care devices for rapid assessment of iMg in critical situations. Notably, hypomagnesemia by iMg was associated with a higher prevalence of diabetes, while hypermagnesemia by both iMg and tMg showed associations with CKD. Dysmagnesemia by iMg did not show an association with poor health outcomes, however, multivariant regression analysis showed that hypermagnesemia by tMg was linked with adverse health outcomes. These findings highlight the importance of further research to examine the complex associations and impacts of dysmagnesemia in various clinical settings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll necessary data are included, and further data are available on reasonable request to the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declared no conflict of interest.\u0026nbsp;The manuscript content has not been published or submitted for publication elsewhere. All the authors reviewed the manuscript and intellectually contributed to the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research was supported by a grant from the Ministry of Higher Education, Research, and Innovation (MOHERI), BFP/GRG/HSS/22/077.\u003c/p\u003e\n\u003cp\u003eNova Biomedical (Waltman, Massachusetts, United States) supplied\u0026nbsp;the\u0026nbsp;electrolytes analyzer for ionized magnesium detection\u0026nbsp;with its consumables (Stat Profile Prime Plus\u0026reg;). Technical support and maintenance services were provided by Nova Biomedical and Global Source Trading.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Medical and Research Ethics Committee at the College of Medicine and Health Sciences, SQU, Muscat, Oman (MREC #2719; SQU-EC/51/2022; dated: April 1\u003csup\u003est\u003c/sup\u003e, 2022).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: AA and HF: Data curation: ZS, DA, QM, MT, AS and RB: Formal analysis: JM: Funding acquisition: AA, and SB: Investigation: AA, JM, ZS and SB: Methodology: AA, JM and ZS: \u0026nbsp;Project administration: AA and JM: Resources: AA, JM, ZS and SB: Machine handling: QM, MT and DA. Supervision: AA and JM. Validation: AA and JM: Drafting the manuscript: AA, SB, HF and JM. Critical review of the manuscript for important intellectual content: All authors.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAl Alawi AM, Al Badi A, Al Huraizi A, Falhammar H. Magnesium: The recent research and developments. Adv Food Nutr Res. 2021;96:193-218.\u003c/li\u003e\n\u003cli\u003eAl Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018;2018:9041694.\u003c/li\u003e\n\u003cli\u003eCheungpasitporn W, Thongprayoon C, Qian Q. Dysmagnesemia in Hospitalized Patients: Prevalence and Prognostic Importance. Mayo Clin Proc. 2015;90(8):1001-10.\u003c/li\u003e\n\u003cli\u003eThongprayoon C, Sy-Go JPT, Nissaisorakarn V, Dumancas CY, Keddis MT, Kattah AG, et al. Machine Learning Consensus Clustering Approach for Hospitalized Patients with Dysmagnesemia. Diagnostics (Basel). 2021;11(11).\u003c/li\u003e\n\u003cli\u003eShin HJ, Han J, Yim S, Do SH. Incidence of ionized hypomagnesemia in adult patients undergoing noncardiac major surgery: a prospective observational trial. Magnes Res. 2022;35(1):11-7.\u003c/li\u003e\n\u003cli\u003eAl Shukri Z, Al-Maqbali JS, Al Alawi AM, Al Riyami N, Al Riyami S, Al Alawi H, et al. Incidence of Dysmagnesemia among Medically Hospitalized Patients and Associated Clinical Characteristics: A Prospective Cohort Study. Int J Endocrinol. 2023;2023:6650620.\u003c/li\u003e\n\u003cli\u003eGautam S, Khapunj A. Prevalence of Hypomagnesemia among Elderly Patients attending a Tertiary Care Center: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021;59(233):35-8.\u003c/li\u003e\n\u003cli\u003eAal-Hamad AH, Al-Alawi AM, Kashoub MS, Falhammar H. Hypermagnesemia in Clinical Practice. Medicina (Kaunas). 2023;59(7).\u003c/li\u003e\n\u003cli\u003eCheungpasitporn W, Thongprayoon C, Bathini T, Hansrivijit P, Vaitla P, Medaura J, et al. Impact of admission serum magnesium levels on long-term mortality in hospitalized patients. Hosp Pract (1995). 2020;48(2):80-5.\u003c/li\u003e\n\u003cli\u003eDel Gobbo LC, Imamura F, Wu JH, de Oliveira Otto MC, Chiuve SE, Mozaffarian D. Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2013;98(1):160-73.\u003c/li\u003e\n\u003cli\u003eAl Alawi AM, Berhane T, Majoni SW, Falhammar H. Characteristics and health outcomes of patients hospitalized with hypomagnesemia: a retrospective study from a single centre in the Northern Territory of Australia. Intern Med J. 2022;52(9):1544-53.\u003c/li\u003e\n\u003cli\u003eAl-Maqbali JS, Al Alawi AM, Al-Falahi Z, Falhammar H, Al-Zakwani I, Al Za\u0026apos;abi M. The Stability of Analytes of Ionized Magnesium Concentration and Its Reference Range in Healthy Volunteers. Biomedicines. 2023;11(9).\u003c/li\u003e\n\u003cli\u003eLanzinger MJ, Moretti EW, Wilderman RF, El-Moalem HE, Toffaletti JG, Moon RE. The relationship between ionized and total serum magnesium concentrations during abdominal surgery. J Clin Anesth. 2003;15(4):245-9.\u003c/li\u003e\n\u003cli\u003eRooney MR, Rudser KD, Alonso A, Harnack L, Saenger AK, Lutsey PL. Circulating Ionized Magnesium: Comparisons with Circulating Total Magnesium and the Response to Magnesium Supplementation in a Randomized Controlled Trial. Nutrients. 2020;12(1).\u003c/li\u003e\n\u003cli\u003eAl-Yarabi A, Al Balushi H, Al Hatmi K, Al Yahyaie R, Al Alawi AM, Al Zeedy K, et al. Inappropriate Hospital Stay of Patients Admitted Under Care of General Medicine Units: A retrospective study. Sultan Qaboos Univ Med J. 2023;23(2):174-81.\u003c/li\u003e\n\u003cli\u003eMalinowska J, Małecka M, Ciepiela O. Variations in Magnesium Concentration Are Associated with Increased Mortality: Study in an Unselected Population of Hospitalized Patients. Nutrients. 2020;12(6).\u003c/li\u003e\n\u003cli\u003eYeh DD, Chokengarmwong N, Chang Y, Yu L, Arsenault C, Rudolf J, et al. Total and ionized magnesium testing in the surgical intensive care unit - Opportunities for improved laboratory and pharmacy utilization. J Crit Care. 2017;42:147-51.\u003c/li\u003e\n\u003cli\u003eScarpati G, Baldassarre D, Oliva F, Pascale G, Piazza O. Ionized or Total Magnesium levels, what should we measure in critical ill patients? Transl Med UniSa. 2020;23:68-76.\u003c/li\u003e\n\u003cli\u003eGagliano V, Sch\u0026auml;ffeler F, Del Giorno R, Bianchetti M, Carvajal Canarte CF, Caballero Regueira JJ, et al. Does Ionized Magnesium Offer a Different Perspective Exploring the Association between Magnesemia and Targeted Cardiovascular Risk Factors? J Clin Med. 2022;11(14).\u003c/li\u003e\n\u003cli\u003eBouillon-Minois JB, Khaled L, Vitte F, Miraillet L, Eschalier R, Jabaudon M, et al. Ionized Magnesium: Interpretation and Interest in Atrial Fibrillation. Nutrients. 2023;15(1).\u003c/li\u003e\n\u003cli\u003eHuijgen HJ, Soesan M, Sanders R, Mairuhu WM, Kesecioglu J, Sanders GT. Magnesium levels in critically ill patients. What should we measure? Am J Clin Pathol. 2000;114(5):688-95.\u003c/li\u003e\n\u003cli\u003eEscuela MP, Guerra M, A\u0026ntilde;\u0026oacute;n JM, Mart\u0026iacute;nez-Vizca\u0026iacute;no V, Zapatero MD, Garc\u0026iacute;a-Jal\u0026oacute;n A, et al. Total and ionized serum magnesium in critically ill patients. Intensive Care Med. 2005;31(1):151-6.\u003c/li\u003e\n\u003cli\u003eHansen BA, Bruserud \u0026Oslash;. Hypomagnesemia in critically ill patients. J Intensive Care. 2018;6:21.\u003c/li\u003e\n\u003cli\u003eCockwell P, Fisher LA. The global burden of chronic kidney disease. Lancet. 2020;395(10225):662-4.\u003c/li\u003e\n\u003cli\u003eGommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? Diabetes. 2016;65(1):3-13.\u003c/li\u003e\n\u003cli\u003ePham PC, Pham PM, Pham PA, Pham SV, Pham HV, Miller JM, et al. Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2. Clin Nephrol. 2005;63(6):429-36.\u003c/li\u003e\n\u003cli\u003eGal\u0026aacute;n Carrillo I, Vega A, Goicoechea M, Shabaka A, Gatius S, Abad S, et al. Impact of Serum Magnesium Levels on Kidney and Cardiovascular Prognosis and Mortality in CKD Patients. J Ren Nutr. 2021;31(5):494-502.\u003c/li\u003e\n\u003cli\u003eSteinberger HA, Hanson CW, 3rd. Outcome-based justification for implementing new point-of-care tests: there is no difference between magnesium replacement based on ionized magnesium and total magnesium as a predictor of development of arrhythmias in the postoperative cardiac surgical patient. Clin Lab Manage Rev. 1998;12(2):87-90.\u003c/li\u003e\n\u003cli\u003eFawcett WJ, Haxby EJ, Male DA. Magnesium: physiology and pharmacology. Br J Anaesth. 1999;83(2):302-20.\u003c/li\u003e\n\u003cli\u003eRay BS. Louise Eisenhardt. 1891-1967. Surg Neurol. 1977;8(4):227-8.\u003c/li\u003e\n\u003cli\u003eVanoni FO, Milani GP, Agostoni C, Treglia G, Fare PB, Camozzi P, et al. Magnesium Metabolism in Chronic Alcohol-Use Disorder: Meta-Analysis and Systematic Review. Nutrients. 2021;13(6).\u003c/li\u003e\n\u003cli\u003eCidade-Rodrigues C, Cunha FM, Elias C, Carreira M, Barroso I, Bettencourt P, et al. The prognostic impact of magnesium in acute heart failure is different according to the presence of diabetes mellitus. Porto Biomed J. 2022;7(6):e197.\u003c/li\u003e\n\u003cli\u003eAngkananard T, Anothaisintawee T, Eursiriwan S, Gorelik O, McEvoy M, Attia J, et al. The association of serum magnesium and mortality outcomes in heart failure patients: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(50):e5406.\u003c/li\u003e\n\u003cli\u003eNasser R, Naffaa ME, Mashiach T, Azzam ZS, Braun E. The association between serum magnesium levels and community-acquired pneumonia 30-day mortality. BMC Infect Dis. 2018;18(1):698.\u003c/li\u003e\n\u003cli\u003eSoliman HM, Mercan D, Lobo SS, Melot C, Vincent JL. Development of ionized hypomagnesemia is associated with higher mortality rates. Crit Care Med. 2003;31(4):1082-7.\u003c/li\u003e\n\u003cli\u003eMcCluskey A, Thomas AN, Bowles BJ, Kishen R. The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit. Anaesthesia. 1996;51(8):724-7.\u003c/li\u003e\n\u003cli\u003eSaha H, Harmoinen A, Karvonen AL, Mustonen J, Pasternack A. Serum ionized versus total magnesium in patients with intestinal or liver disease. Clin Chem Lab Med. 1998;36(9):715-8.\u003c/li\u003e\n\u003cli\u003eKulpmann WR, Rossler J, Brunkhorst R, Schuler A. Ionised and total magnesium serum concentrations in renal and hepatic diseases. Eur J Clin Chem Clin Biochem. 1996;34(3):257-64.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 1\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e:\u003c/em\u003e Characteristics, clinical features, and laboratory profiles of the admitted patients categorized according to \u003cem\u003eionized\u003c/em\u003e Mg concentrations.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"660\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en (%) unless specified otherwise\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e500 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 0.46\u003c/p\u003e\n \u003cp\u003emmol/L\u003c/p\u003e\n \u003cp\u003e17 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0.47-0.68 mmol/L\u003c/p\u003e\n \u003cp\u003e350 (70.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 0.69 mmol/L\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e133 (26.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eFemale sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e246 (49.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e10 (58.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e175 (50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e61 (45.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAge; IQR, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e64.5 (48 \u0026ndash; 77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e69 (59 \u0026ndash; 75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e64.5 (48 \u0026ndash; 77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e64 (48 \u0026ndash; 78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eBMI; IQR, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25.81 (23.35 \u0026ndash; 29.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e26.26 (25.40 \u0026ndash; 29.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25.99 (23.63 \u0026ndash; 29.73)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e25.71 (22.57 \u0026ndash; 28.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical History\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e330 (66.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e13 (76.47%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e232 (66.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e85 (63.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiabetes Mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e262 (52.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e14 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e192 (54.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e56 (42.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eChronic Kidney Disease\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e122 (24.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (23.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e73 (20.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e45 (33.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eESRD (dialysis)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e19 (3.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e13 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e6 (4.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eHeart Failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e103 (20.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (29.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e71 (20.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e27 (20.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eIrritable bowel syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAutoimmune Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e8 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e6 (1.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eRefeeding Syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCeliac Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eBariatric Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAlcohol consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e48 (9.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e33 (9.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e14 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eSmoking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e35 (7.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25 (7.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e8 (6.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eIVDU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e10 (2.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e5 (3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eLoop diuretics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e193 (38.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e7 (41.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e129 (36.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e57 (42.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eThiazides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e51 (10.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e42 (12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e8 (6.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eProton pump inhibitors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e389 (77.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e13 (76.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e279 (79.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e97 (72.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eGentamicin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.86%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAmikacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e22 (4.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (22.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e16 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e4 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eParomomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAmphotericin B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e3 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eTacrolimus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCyclosporine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary diagnosis according to ICD10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eInfectious disease (A00-B99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e66 (13.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e48 (13.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e16 (12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eEndocrine, nutritional, and metabolic diseases (E00-E99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e38 (7.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e30 (8.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e7 (5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the nervous system (G03-G72)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25 (5.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e16 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e9 (6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the circulatory system (I16-I99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e117 (23.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e7 (41.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e83 (23.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e27 (20.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the respiratory system (J00-J99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e79 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (11.76%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e56 (16.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e21 (12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the digestive system (K00-K93)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e39 (7.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e30 (8.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e9 (6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the genitourinary system (N00-N99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e45 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e30 (8.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e14 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e91 (18.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (23.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e57 (16.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e30 (22.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eElectrolytes (serum or plasma)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAlbumin, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e38 (34 \u0026ndash; 43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e36 (36 \u0026ndash; 40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e38 (34 \u0026ndash; 43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e39 (35 \u0026ndash; 43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCorrected Calcium, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.24 \u0026ndash; 2.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.18 \u0026ndash; 2.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.23 \u0026ndash; 2.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.21 \u0026ndash; 2.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eSodium, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e136 (133 \u0026ndash; 139)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e138 (135 \u0026ndash; 139)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e136 (133 \u0026ndash; 138)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e137 (133 \u0026ndash; 139)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003ePotassium, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 (3.9 \u0026ndash; 4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 (4.0 \u0026ndash; 4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 (3.9 \u0026ndash; 4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 (4.0 \u0026ndash; 4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eChloride, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e101 (97 \u0026ndash; 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e100 (98 \u0026ndash; 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e101 (97 \u0026ndash; 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e102 (98 \u0026ndash; 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCreatinine, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e80 (58 \u0026ndash; 127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e74 (55 \u0026ndash; 78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e78 (57 \u0026ndash; 111)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e92 (63 \u0026ndash; 184)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eeGFR, IQR, ml/min/1.73 m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e80 (90 \u0026ndash; 42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e90 (69 \u0026ndash; 90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e83 (51 \u0026ndash; 90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e60 (31 \u0026ndash; 90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypomagnesemia Treatment (Mg replacement)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eMg replacement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e104 (20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e10 (58.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e76 (21.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e18 (13.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eIV Mg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e99 (19.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e10 (58.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e72 (20.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e17 (12.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eOral Mg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eTotal dose of Mg replacement; IQR, gram\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0 \u0026ndash; 6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eBMI; Body Mass Index, ESRD; End Stage Renal Disease, and IVDU; Intravenous Drug User.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 2\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e:\u003c/em\u003e Characteristics, clinical features, and laboratory profiles of the admitted patients categorized according to \u003cem\u003etotal\u003c/em\u003e Mg concentrations.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"660\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en (%) unless specified otherwise\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e500 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 0.69 mmol/L\u003c/p\u003e\n \u003cp\u003e66 (13.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0.70-1.00 mmol/L\u003c/p\u003e\n \u003cp\u003e379 (75.8%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 1.01 mmol/L\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e55\u0026nbsp;(11.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eFemale sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e246 (49.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e38 (57.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e184 (48.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e24 (43.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAge; IQR, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e64.5 (48 \u0026ndash; 77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e61.5 (46 \u0026ndash; 75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e65 (48 \u0026ndash; 77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e66 (47 \u0026ndash; 80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eBMI; IQR, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25.81 (23.35 \u0026ndash; 29.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e26.97 (23.87 \u0026ndash; 29.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e26.00 (23.72 \u0026ndash; 29.73)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e25.40 (20.80 \u0026ndash; 27.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical History\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e330 (66.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e45 (68.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e246 (64.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e39 (70.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiabetes Mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e262 (52.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e42 (63.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e193 (50.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e27 (49.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eChronic Kidney Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e122 (24.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e11 (16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e87 (23.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e24 (43.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eESRD (dialysis)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e19 (3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e12 (3.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e6 (10.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eHeart Failure\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e103 (20.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e12 (18.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e75 (19.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e16 (20.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eIrritable bowel syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAutoimmune Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e8 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e6 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eRefeeding Syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCeliac Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eBariatric Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAlcohol consumption\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e48 (9.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e7 (10.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e34 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e7 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eSmoking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e35 (7.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e24 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e5 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eIVDU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e10 (2.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e8 (2.11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eLoop diuretics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e193 (38.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e17 (25.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e146 (38.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e30 (54.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eThiazides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e51 (10.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (7.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e42 (11.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e4 (7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eProton pump inhibitors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e389 (77.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e51 (77.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e294 (77.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e44 (80.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eGentamicin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAmikacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e22 (4.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e17 (4.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eParomomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAmphotericin B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eTacrolimus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCyclosporine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e1 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary diagnosis according to ICD10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eInfectious disease (A00-B99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e66 (13.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e14 (21.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e45 (11.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e7 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eEndocrine, nutritional, and metabolic diseases (E00-E99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e38 (7.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25 (6.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e7 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the nervous system (G03-G72)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e25 (5.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e17 (4.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e5 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the circulatory system (I16-I99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e117 (23.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e12 (18.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e98 (25.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e7 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the respiratory system (J00-J99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e79 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e71 (18.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e6 (10.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the digestive system (K00-K93)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e39 (7.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e9 (13.64%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e24 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e6 (10.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eDiseases of the genitourinary system (N00-N99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e45 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e7 (10.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e31 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e7 (12.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e91 (18.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e13 (19.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e68 (17.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e10 (18.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eElectrolytes (serum or plasma)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eAlbumin, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e38 (34 \u0026ndash; 43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e36 (33 \u0026ndash; 41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e39 (34 \u0026ndash; 43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e38 (35 \u0026ndash; 42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCorrected Calcium, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.24 \u0026ndash; 2.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.20 \u0026ndash; 2.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2.30 (2.23 \u0026ndash; 2.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e2.29 (2.21 \u0026ndash; 2.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eSodium, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e136 (133 \u0026ndash; 139)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e136 (132 \u0026ndash; 139)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e136 (133 \u0026ndash; 138)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e136 (133 \u0026ndash; 140)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003ePotassium, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 (3.9 \u0026ndash; 4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4.2 (3.9 \u0026ndash; 4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e4.3 (3.9 \u0026ndash; 4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e4.8 (4.1 \u0026ndash; 5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eChloride, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e101 (97 - 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e101 (98 \u0026ndash; 105)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e101 (97 \u0026ndash; 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e101 (97 \u0026ndash; 104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eCreatinine, IQR, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e80 (58 \u0026ndash; 127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e72 (53 \u0026ndash; 99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e78 (56 \u0026ndash; 111)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e189 (92 \u0026ndash; 337)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eeGFR, IQR, ml/min/1.73 m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e80 (90 \u0026ndash; 42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e89 (57 \u0026ndash; 90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e83 (52 \u0026ndash; 90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e29 (14 \u0026ndash; 55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypomagnesemia Treatment (Mg replacement)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eMg replacement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e104 (20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e37 (56.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e59 (15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e8 (14.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eIV Mg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e99 (19.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e34 (51.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e75 (13.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e8 (14.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eOral Mg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e5 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e3 (4.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25%\" valign=\"top\"\u003e\n \u003cp\u003eTotal dose of Mg replacement; IQR, gram\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0 \u0026ndash; 4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.515151515151516%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.363636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eBMI; Body Mass Index, ESRD; End Stage Renal Disease, and IVDU; Intravenous Drug User.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 3\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e:\u003c/em\u003e Patient clinical outcomes classified according to \u003cem\u003eionized\u0026nbsp;\u003c/em\u003eMg concentrations.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"654\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en (%) unless specified otherwise\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e500 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 0.46\u003c/p\u003e\n \u003cp\u003emmol/L\u003c/p\u003e\n \u003cp\u003e17 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e0.47-0.68 mmol/L\u003c/p\u003e\n \u003cp\u003e350 (70.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 0.69 mmol/L\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e133 (26.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eLength of stay, IQR, (Days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e4.54 (2.53 \u0026ndash; 9.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e4.7 (3.41 \u0026ndash; 9.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e4.54 (2.47 \u0026ndash; 8.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e4.51 (2.67 \u0026ndash; 10.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eHigh Dependency Unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e116 (23.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e5 (29.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e76 (21.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e35 (26.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of Ventricular Fibrillation after admission\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.57%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of Ventricular Tachycardia after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e6 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e4 (1.14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of\u0026nbsp;Atrial Fibrillation\u0026nbsp;after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e56 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e4 (23.53%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e34 (9.71%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e18 (13.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eCardiac arrest\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e46 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e29 (8.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e15 (11.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eInpatient mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e36 (7.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e25 (7.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e11 (8.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003e90-day readmission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e82 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e60 (17.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e20 (15.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003e6-month all-cause mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e63 (12.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e3 (17.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e40 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e20 (15.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 4\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e:\u003c/em\u003e Patient clinical outcomes classified according to \u003cem\u003etotal\u0026nbsp;\u003c/em\u003eMg concentrations.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"654\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en (%) unless specified otherwise\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e500 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 0.69 mmol/L\u003c/p\u003e\n \u003cp\u003e66 (13.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e0.70-1.00 mmol/L\u003c/p\u003e\n \u003cp\u003e379 (75.8%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 1.01 mmol/L\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e55\u0026nbsp;(11.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eLength of stay, IQR, (Days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e4.47 (2.52 \u0026ndash; 9.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e5.33 (3.46 \u0026ndash; 10.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e4.35 (2.41 \u0026ndash; 8.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e4.51 (2.92 \u0026ndash; 10.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eHigh Dependency Unit\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e116 (23.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e14 (21.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e81 (21.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e21 (38.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of Ventricular Fibrillation after admission\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of Ventricular Tachycardia after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e6 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.06%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e4 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of\u0026nbsp;Atrial Fibrillation (AF)\u0026nbsp;after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e56 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e7 (10.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e41 (10.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e8 (14.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eCardiac arrest\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e46 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e29 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e11 (20.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003eInpatient mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e36 (7.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e4 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e26 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e6 (10.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003e90-day readmission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e82 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e11 (16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e58 (15.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e13 (23.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.027522935779814%\" valign=\"top\"\u003e\n \u003cp\u003e6-month all-cause mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e63 (12.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e6 (9.09%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e44 (11.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e13 (23.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 5\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e:\u003c/em\u003e Patient clinical outcomes classified according to \u003cem\u003efraction\u0026nbsp;\u003c/em\u003e(iMg/tMg) concentration.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"654\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en (%) unless specified otherwise\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e500 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 60%\u003c/p\u003e\n \u003cp\u003e19 (3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e61-80%\u003c/p\u003e\n \u003cp\u003e335 (67.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 81%\u003c/p\u003e\n \u003cp\u003e146 (29.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eLength of stay, IQR, (Days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e4.47 (2.52 \u0026ndash; 9.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e3.24 (1.77 \u0026ndash; 6.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e4.50 (2.54 \u0026ndash; 8.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e4.57 (2.66 \u0026ndash; 10.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eHigh Dependency Unit\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e116 (23.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e11 (57.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e70 (20.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e35 (24.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of Ventricular Fibrillation after admission\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e1 (0.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of Ventricular Tachycardia after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e6 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e3 (0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e3 (2.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eDevelopment of\u0026nbsp;Atrial Fibrillation (AF)\u0026nbsp;after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e56 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e41 (12.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e13 (8.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eCardiac arrest\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e46 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e7 (36.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e29 (8.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e10 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003eInpatient mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e36 (7.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e7 (36.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e15 (5.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e11 (7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003e90-day readmission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e82 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e3 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e58 (17.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e21 (14.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.944954128440365%\" valign=\"top\"\u003e\n \u003cp\u003e6-month all-cause mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.761467889908257%\" valign=\"top\"\u003e\n \u003cp\u003e63 (12.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.844036697247706%\" valign=\"top\"\u003e\n \u003cp\u003e9 (47.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.678899082568808%\" valign=\"top\"\u003e\n \u003cp\u003e41 (12.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.596330275229358%\" valign=\"top\"\u003e\n \u003cp\u003e13 (8.9 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.174311926605505%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 6\u003c/em\u003e\u003c/strong\u003e: Multivariate logistic regression for independent factors associated with \u003cem\u003etotal\u003c/em\u003e Mg\u0026nbsp;concentrations\u0026nbsp;and\u0026nbsp;clinical outcomes (HDU, cardiac arrest and 6-month mortality).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"540\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.555555555555557%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome tested in the model\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent factors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR* [95% CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.555555555555555%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.555555555555557%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHigh Dependency Unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u0026nbsp;\u003c/em\u003eMg concentration\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e4.34 [1.24 - 15.06]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.555555555555555%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eFrusemide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e3.09 [1.99 - 4.79]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.555555555555557%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eCardiac arrest\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u0026nbsp;\u003c/em\u003eMg concentration\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e14.64 [3.04 - 70.57]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.555555555555555%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e0.48 [0.24 - 0.95]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eAlbumin mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e0.93 [0.88 \u0026ndash; 0.96]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eFrusemide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e3.29 [1.61 - 6.72]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.555555555555557%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e6-month mortality\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u0026nbsp;\u003c/em\u003eMg concentration\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e11.44 [2.46 - 53.17]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.555555555555555%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eAlbumin mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e0.89 [0.85 \u0026ndash; 0.93]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eFrusemide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e1.91 [1.04 - 3.51]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.791044776119406%\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.3134328358209%\" valign=\"top\"\u003e\n \u003cp\u003e1.03 [1.01 - 1.05]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.895522388059703%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e*Backward stepwise\u0026nbsp;\u003c/em\u003e\u003cem\u003emulti\u003c/em\u003e\u003cem\u003e-regression model for an adjusted odds ratio (aOR) for the following relevant factors that includes total Mg\u0026nbsp;\u003c/em\u003e\u003cem\u003econcentrations\u003c/em\u003e\u003cem\u003e, age, female, body mass index, diabetes, hypertension, chronic kidney disease, heart failure, potassium, sodium, creatinine, estimated\u0026nbsp;\u003c/em\u003e\u003cem\u003eglomerular\u003c/em\u003e\u003cem\u003e\u0026nbsp;filtration rate, albumin, frusemide, and Mg correction/treatment.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"emmd","sideBox":"Learn more about [BMC Emergency Medicine](http://bmcemergmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/emmd","title":"BMC Emergency Medicine","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Ionized magnesium, total magnesium, Hypomagnesemia, Hypermagnesemia, Hospitalization, Mortality, Cardiac Arrest","lastPublishedDoi":"10.21203/rs.3.rs-4286385/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4286385/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cem\u003eIntroduction\u003c/em\u003e: Ionized Mg (iMg) may offer a more reliable indicator of Mg status during acute illness than total body Mg (tMg) concentrations. This study aimed to determine the incidence of dysmagnesemia and their relationship using iMg and tMg. The clinical and biochemical characteristics as well as health outcomes and their association with iMg and tMg was also assessed.\u003c/p\u003e \u003cp\u003e \u003cem\u003eMethods\u003c/em\u003e: A prospective study including all eligible adult patients (\u0026ge;\u0026thinsp;18 years) who were hospitalized in the General Internal Medicine unit at Sultan Qaboos University Hospital (SQUH) for 3.5 months in 2023. The iMg and tMg concentrations were collected on all at the admission.\u003c/p\u003e \u003cp\u003e \u003cem\u003eResults\u003c/em\u003e: In total 500 patients were included (females (49.2%)) with a median age of 64.5 years (IQR: 48\u0026ndash;77). The prevalence of hypomagnesemia and hypermagnesemia by iMg concentrations was 3.4% and 26.6%, respectively, while by tMg concentrations 13.2% and 11.0%, respectively. The agreement between both measurements was strong (r\u0026thinsp;=\u0026thinsp;0.665, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). An increased tMg concentration was independently associated high dependency units\u0026rsquo; admission (adjusted odds ratio (aOR): 4.34, 95%CI: 1.24\u0026ndash;15.06, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02) and cardiac arrest (aOR: 14.64, 95%CI: 3.04\u0026ndash;70.57, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and 6-month all-cause mortality (aOR: 11.44, 95%CI: 2.46\u0026ndash;53.17, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). During follow-up hypermagnesemia using tMg had a higher mortality compared to other groups (hazard ratio (HR): 1.82, 95%CI: 1.11\u0026ndash;3.01, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02) while no significant findings were demonstrated using iMg concentrations.\u003c/p\u003e \u003cp\u003e \u003cem\u003eConclusion\u003c/em\u003e: iMg and tMg concentrations had a strong correlation supporting the use of point-of-care devices for rapid assessment in critical situations. The difference in the associations with health outcomes highlights the importance of further research.\u003c/p\u003e \u003cp\u003eWordcounts: 249\u003c/p\u003e","manuscriptTitle":"Dysmagnesemia Measured by Ionized and Total Body Concentrations Among Medically Hospitalized Patients: Incidence, Clinical Characteristics, and Health Outcomes - A Prospective Cohort Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-29 12:33:36","doi":"10.21203/rs.3.rs-4286385/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"checksComplete","content":"","date":"2024-04-19T06:11:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-19T06:11:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Emergency Medicine","date":"2024-04-18T08:49:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"emmd","sideBox":"Learn more about [BMC Emergency Medicine](http://bmcemergmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/emmd","title":"BMC Emergency Medicine","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"28775e68-e42c-4d59-b96f-d83d328f6830","owner":[],"postedDate":"April 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-04-29T12:33:37+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-29 12:33:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4286385","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4286385","identity":"rs-4286385","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}