Association between Serum Magnesium and all-cause mortality in patients with Sepsis-associated liver injury: A Cohort Study

Background Serum magnesium is critical for cellular function and impaired magnesium homeostasis is associated with increased mortality in critically ill patients. However, its role in sepsis-associated liver injury (SALI) remains unclear. This study aims to elucidate the association between serum magnesium and all-cause mortality in patients with SALI. Methods Data for this retrospective cohort study were obtained from the Medical Information Mart in Intensive Care IV (MIMIC-IV), which included the initial serum magnesium levels of patients diagnosed with SALI admitted to the ICU. Multivariable Cox regression analysis, Kaplan-Meier survival curves, and restricted cubic spline (RCS) were used to assess the association between serum magnesium levels on admission to the ICU and in-hospital mortality in patients with SALI. Results A total of 1367 patients were enrolled in the study with an in-hospital mortality rate of 34.97%. Multivariate Cox regression analysis showed that in-hospital mortality in patients with SALI increased with increasing serum magnesium levels at ICU admission, HR 1.28 (1.06–1.53, p 0.009). RCS suggests a nonlinear association between serum magnesium levels and in-hospital mortality in patients with SALI. Conclusions This study found that high serum magnesium levels were independently associated with in-hospital mortality in patients with SALI, showing a nonlinear association. Nevertheless, confirmation of this association requires further validation through large-scale prospective cohort studies.