ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1616294
Early administration of magnesium sulfate and its impact on clinical outcomes in ICU-admitted patients with COPD: A retrospective cohort study
Provisionally accepted
- Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Background: Magnesium sulfate is commonly utilized in critical care due to its vasodilatory, bronchodilatory, and neuroprotective properties. However, its impact on mortality outcomes in patients with chronic obstructive pulmonary disease (COPD) requiring intensive care remains inadequately defined. Methods: A retrospective cohort study was conducted on patients with COPD who were admitted to the ICU at Beth Israel Deaconess Medical Center in Boston from 2008 to 2019. Early administration of magnesium sulfate was considered for intravenous administration within 48 hours of ICU admission. Propensity-score-based methods, such as inverse probability weighting, were employed to evaluate the correlation between early use of magnesium sulfate and 28-day mortality. Results: A total of 3,651 ICU admissions for COPD were included, of which 1,148 (31.4%) patients received magnesium sulfate within the first 48 hours. Administering magnesium sulfate early was linked to a reduced 28-day mortality rate (hazard ratio 0.76, 95% confidence interval 0.60–0.95), with consistent results across predefined subgroups. This correlation remained consistent regardless of baseline serum magnesium levels and did not increase the risk of acute kidney injury (AKI). The calculated E-value of 1.96 indicates that significant unmeasured confounding factors would be necessary to fully account for the observed relationship. Conclusions: In this single-center retrospective cohort, early magnesium sulfate administration in critically ill patients with COPD was associated with lower 28-day mortality without an observed increase in AKI risk. These results advocate for prospective multicenter studies to validate these connections, investigate optimal dosing approaches, and pinpoint the patient subgroups most likely to benefit from this intervention.
Keywords: Magnesium Sulfate, COPD, Critical Care, prognosis, MIMIC-IV
Received: 22 Apr 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Xiao, Chen, Ding and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shan Lin, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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