Serum electrolyte levels in predicting outcomes of patients with traumatic brain injury: A retrospective study

Abstract text (incl. references and figure legends)

Introduction

Electrolyte derangements are a common sequel of traumatic brain injury (TBI) which may lead to the death of patients or prolong their hospital stay [1,2]. The study aims to determine the role of electrolyte imbalance in predicting the in-hospital mortality of patients with severe TBI.

Material & Methods

A retrospective analysis of data on ICU-admitted TBI patients in the Hamad Trauma Center (HTC) between mid-2016 and mid-2021 was conducted. Serum levels of electrolytes (sodium, potassium, calcium, magnesium, phosphorus) were collected at the time of admission. Comparative analyses between in-hospital survivors and non-survivors were performed. Univariate and multivariate logistic regression analyses were performed to determine the predictive role of different variables on mortality.

Results

A total of 922 patients were included in the study. The mean age was 32 years; 94% were males. Road traffic injuries (59%) were the most frequent cause of TBI, followed by falls (25%). Subarachnoid hemorrhage (42%) and subdural hematoma (35%) were more common. The prevalence of electrolyte imbalances was hypocalcemia (82%) hypophosphatemia (67%), hypokalemia (35%), and hypomagnesemia (31%). In-hospital mortality was 22%. The multivariate logistic regression revealed that hypocalcemia was a significant predictor of mortality (Adjusted Odds Ratio:0.33, 95% CI: 0.12-0.93, p-value 0.04) along with high shock index, low GCS, high head AIS, hyperglycemia and prolonged activated partial thromboplastin time.

Conclusion

Hypocalcemia is significantly associated with increased trauma-induced coagulopathy and higher post-injury mortality. Calcium supplementation should be the first-tier treatment for high-risk injuries.

References

Bruns J Jr, Hauser WA. The epidemiology of traumatic brain injury: a review. Epilepsia. 2003; 44(suppl 10):2-10. Fleminger S, Ponsford J. Long term outcome after traumatic brain injury. BMJ. 2005;331:1419-1420

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