INTRODUCTION The significance of hypomagnesemia and the need for treatment are under-recognized in clinical practice. Our objective was to design, establish, and test two interventions to screen for patients with hypomagnesemia and increase the rate of treatment of hypomagnesemia in the Emergency Department (ED). MATERIAL AND METHODS A prospective two-year study was conducted. The Laboratory Information System was set to automatically order plasma magnesium in ED patients with plasma calcium < 7.5 mg/dL (1.9 mmol/L) and/or plasma potassium < 2.5 mEq/L (2.5 mmol/L). We counted the number of identified cases of hypomagnesemia, and calculated the total economic cost per identified patient. The study had three periods "Central lab" "Stat lab" and "Stat lab with comment" according to the availability to measure plasma magnesium levels in the stat laboratory and the inclusion of an automatic comment in the laboratory report in cases of hypomagnesemia. We retrospectively reviewed the medical records of patients with magnesium < 1.5 mg/dL (0.6 mmol/L), to investigate whether they have been appropriately treated. RESULTS A total of 410 plasma magnesium were measured due to our intervention; 179 due to hypokalemia and 231 due to hypocalcemia. Two hundred thirty (56.1%) of 410 showed hypomagnesemia. Each detected case resulted in reagent cost of 0.7$, when prompted by hypocalcemia, and 0.6$ when prompted by hypokalemia. The rate of patients with hypomagnesemia that were appropriately treated increased from 15% to 75% along the study period. CONCLUSIONS Our strategies successfully identified patients with hypomagnesemia in the ED at a very affordable cost, and increased the percentage of patients with hypomagnesemia that received treatment.

中文翻译：

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在急诊科，自动进行实验室干预以掩盖和治疗低镁血症。

简介低镁血症的重要性和治疗需求在临床实践中未得到充分认识。我们的目标是设计，建立和测试两种干预措施，以筛查低镁血症患者并提高急诊室（ED）低镁血症的治疗率。材料与方法进行了为期两年的前瞻性研究。实验室信息系统设置为自动订购血浆钙<7.5 mg / dL（1.9 mmol / L）和/或血浆钾<2.5 mEq / L（2.5 mmol / L）的ED患者血浆镁。我们计算了发现的低镁血症病例的数量，并计算了每位确定的患者的总经济成本。该研究分为三个阶段：“中央实验室”，“统计实验室”和“带评论的统计实验室” 根据统计实验室中血浆镁水平的可用性，以及在低镁血症情况下在实验室报告中包含自动注释。我们回顾性地回顾了镁<1.5 mg / dL（0.6 mmol / L）患者的病历，以调查他们是否得到了适当的治疗。结果由于我们的干预，总共测量了410个血浆镁。179因低钾血症而231因低钙血症。410名患者中有230名（56.1％）显示为低镁血症。在低血钙症的提示下，每个检测到的病例导致的试剂成本为0.7 $，在低血钾症的提示下，试剂成本为0.6 $。在研究期间，经过适当治疗的低镁血症患者的比率从15％增加到75％。