Magnesium Not Recommended After Subarachnoid Bleed

Randomized trial concurs with meta-analysis indicating no benefit for reduction of poor outcome

FRIDAY, May 25 (HealthDay News) -- For patients with aneurysmal subarachnoid hemorrhage, intravenous magnesium sulfate is no better than placebo for reduction of poor outcome, according to a study published online May 25 in The Lancet to coincide with presentation at the European Stroke Conference, held from May 22 to 25 in Lisbon, Portugal.

Sanne M. Dorhout Mees, M.D., from the Utrecht Stroke Center in the Netherlands, and colleagues conducted a phase 3 trial in which adult patients with an aneurysmal subarachnoid hemorrhage, who were admitted to hospital within four days of hemorrhage, were randomly allocated to receive 64 mmol/day intravenous magnesium sulfate (606 patients) or placebo (597 patients). The primary end point was poor outcome at three months after hemorrhage (score of 4 to 5 on the modified Rankin Scale) or death.

The researchers found that 26.2 percent of patients in the magnesium group and 25.3 percent in the placebo group had poor outcome (risk ratio [RR], 1.03; 95 percent confidence interval [CI], 0.85 to 1.25). In an updated meta-analysis of seven randomized trials involving 2,047 patients, magnesium treatment after aneurysmal subarachnoid hemorrhage was not superior to placebo for reducing poor outcome (RR, 0.96; 95 percent CI, 0.86 to 1.08).

"Intravenous magnesium sulfate does not improve clinical outcome after aneurysmal subarachnoid hemorrhage, therefore routine administration of magnesium cannot be recommended," the authors conclude.

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