Pre- and Post-Operative Hypomagnesaemia and Association with Adverse Outcomes in Elective Vascular Surgery

Sillo T, Ahmad M, Becker H, Garnham A and Wall M

Department of Vascular Surgery, Russells Hall Hospital, UK
Department of Vascular Anaesthesia, Russells Hall Hospital, UK

^*Correspondance to: T O Sillo 

 PDF  Full Text DOI: 10.25107/2474-1647.1356

Abstract

Objectives: We aimed to establish the incidence of pre- and post-operative hypomagnesaemia in patients having major elective vascular surgery, and the association with post-operative complications.Design: A prospective analysis of patients undergoing major elective vascular surgical procedures in a regional vascular centre was performed over an eight-month period.
Materials and Methods: On-line electronic patient records (EPR) were used to obtain pre-operative serum magnesium levels, as well as first and second day post-operative titers. Hypomagnesaemia was identified as serum magnesium <0.7 mmol/L. Adverse outcomes were identified using a combination of EPR and written records.Results: We identified 256 patients. The commonest procedures were lower limb bypass, carotid endarterectomy (CEA), endovascular aneurysm repair (EVAR), femoral endarterectomy and open aortic aneurysm repair (OAR). Pre-operative hypomagnesaemia was found in 9.0%. Post-operative hypomagnesaemia was detected in 31.3%. De novo post-operative hypomagnesaemia occurred in 26.7%. The relative risk (RR) of cardiovascular complications in hypomagnesaemic patients was 2.20 (95% confidence interval (CI) =1.10–4.40, p=0.03). The RR of non-cardiovascular complications was 1.76 (95% CI=1.04–2.98, p=0.05). The combined RR of any complications in hypomagnesaemic patients was 2.07 (95% CI 1.40–3.08, p=0.0007). The mean post-operative length of stay (LOS) was 6.7 days in hypomagnesaemic patients, and 4.3 days in other patients (p =0.0018).
Conclusion: Pre- and post-operative hypomagnesaemia are common in patients undergoing elective vascular surgery. Post-operative hypomagnesaemia is associated with post-operative complications and increased length of stay.

Keywords

Vascular diseases; Magnesium; Cardiovascular abnormalities; Postoperative complications; Length of stay

Cite the article

Sillo T, Ahmad M, Becker H, Garnham A, Wall M. Pre- and Post-Operative Hypomagnesaemia and Association with Adverse Outcomes in Elective Vascular Surgery. Clin Surg. 2017; 2: 1356.