Association Between Hypomagnesemia and Coagulopathy in Sepsis

Sepsis is a life-threatening condition characterized by organ dysfunction resulting from a dysregulated host response to infection. It remains a major global cause of morbidity and mortality in intensive care units (ICUs).

Hypomagnesemia, commonly observed in ICU patients, has been associated with poor outcomes, including increased need for mechanical ventilation and extended ICU stays. Its immunomodulatory and vasoprotective functions make it a key factor in sepsis pathophysiology.

Inclusion criteria

• Age ≥ 20 years at the time of Intensive Care Unit (ICU) admission.
• Diagnosis of sepsis based on Sepsis-3 criteria [confirmed or suspected infection + Sequential Organ Failure Assessment (SOFA) score ≥ 2].
• Admission to the ICU during the study period.
• Serum magnesium level measured at ICU admission.
• Coagulation parameters [e.g., platelet count, Prothrombin Time/International Normalized Ratio (PT-INR), fibrinogen, D-dimer] within 24 hours of ICU admission.
• Complete clinical and laboratory data for calculating the International Society on Thrombosis and Haemostasis (ISTH) overt Disseminated Intravascular Coagulation (DIC) score.

Exclusion criteria

• Patients with missing data on serum magnesium or coagulation markers at ICU admission.
• ICU admissions due to non-infectious causes (e.g., trauma, elective surgery without infection).
• Presence of pre-existing coagulopathy or hematologic malignancy affecting baseline coagulation (e.g., leukemia, hemophilia).
• Known history of magnesium supplementation prior to ICU admission.
• End-stage renal disease on dialysis, which may significantly alter magnesium handling.
• Pregnant women, due to altered magnesium physiology.
• Patients transferred from or to another hospital within 24 hours of ICU admission (incomplete follow-up).