Effect of Traumatic Brain Injury on Serum Magnesium

Objectives: To assess the effect on serum magnesium levels after traumatic brain injury. Methods: The study was conducted in the Neurosurgery Ward of Mayo Hospital Lahore, Pakistan. A total of 51 patients were included in the study. All the patients who presented with traumatic brain injury and were admitted for management in Neurosurgery Ward in the last six months of 2020 were included in this study. The blood sample for serum magnesium level was taken and recorded. A control group of similar age group with no disease was also included and their samples of serum Mg were taken for comparison with the test group. The post - admission trend of serum magnesium levels of all the participants after TBI was extrapolated and evaluated. Reference range of Normal serum magnesium level is 1.6 to 2.6mEq/L according to ABIM (American Board of Internal Medicine) Laboratory Test Reference Ranges January 2021. Results: A total of 51 participants with a mean age of 32 ? 15SD were included in the study. Among them, 41 were males and 10 were females. The most common cause of traumatic brain injury was found to be road traffic accident (RTA).40 out of 51 patients had a history of RTA making it up to 78%. Second most common cause was the presentation after a fall i. e.9out of 51; mostly involving elderly people. The serum magnesium level in all the 51 participants was collected and graphed.71% patients had a drop in magnesium level from standard minimum reference value i. e.1.6 mEq/L (i. e.1.9m/dl). The mean value of serum magnesium level was calculated as 1.68 ? 0.3sd. The control group (no disease) with the same number of participants and similar age group had their mean serum magnesium level of 2.3 ? 0.2 mg/dl. The p - value was calculated to be 0.00001 which was considered significant statistically (p=less than0.05). Conclusions: Serum magnesium levels decline after traumatic brain injury due to various complex cascades. This decreasing trend has a significant impact on the prognosis of the TBI patients as according to literature magnesium has a role in preventing secondary brain injury mechanisms. By extrapolating evident hypomagnesemia, this study highlights the need for conducting trials to add magnesium supplementation in managing patients with TBI.