Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury
Background: Secondary brain insults after traumatic brain injury such as electrolyte dysfunctions are associated with poor outcomes. This study aimed at determining the incidence of serum sodium ion abnormalities and their association with clinico-radiological parameters. Methods: A prospective cros...
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| Format: | Article |
| Language: | English |
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Surgical Society of Kenya
2021-07-01
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| Series: | The Annals of African Surgery |
| Subjects: | |
| Online Access: | https://www.annalsofafricansurgery.com/sodium-severe-brain-injury |
| _version_ | 1818883901218619392 |
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| author | Philip Mwachaka Angela Amayo Nimrod Mwang’ombe Peter Kitunguu |
| author_facet | Philip Mwachaka Angela Amayo Nimrod Mwang’ombe Peter Kitunguu |
| author_sort | Philip Mwachaka |
| collection | DOAJ |
| description | Background: Secondary brain insults after traumatic brain injury such as electrolyte dysfunctions are associated with poor outcomes. This study aimed at determining the incidence of serum sodium ion abnormalities and their association with clinico-radiological parameters. Methods: A prospective cross-sectional study of one hundred and seventeen patients with severe head injury. Data collected included patient demographics, prehospital interventions, clinical examination findings, computed tomography (CT) scan head findings, serum sodium ion levels (at admission and 48 h later), and outcome (30 days). Results: At admission, 93(79.5%) patients had normal serum sodium ion levels. However, 48 h post-admission, hypernatremia was prevalent in 56(63.6%) patients (p < 0.001). Hypernatremia was significantly associated with the use of mannitol (p = 0.036), lower Glasgow Coma Score (p = 0.047), higher Injury Severity Score (p = 0.015), presence of subdural hematoma (p = 0.044), midline shift >5 mm (p = 0.048), compressed/absent basal cistern (p = 0.010), and higher Rotterdam CT Score (p = 0.003). Hypernatremia reported 48 h post-admission was associated with a high 30-day mortality rate [odds ratio (OR) 3.55, p = 0.0095]. Risk of mortality associated with hyponatremia and hypernatremia at admission was not statistically significant. Conclusion: While both hyponatremia and hypernatremia can occur in serious TBI patients, hypernatremia predominates 48 hours post-admission and is associated with statistically significant increased risk of death. |
| first_indexed | 2024-12-19T15:41:01Z |
| format | Article |
| id | doaj.art-02465435b7cc4bd896c6c249077deedb |
| institution | Directory Open Access Journal |
| issn | 1999-9674 2523-0816 |
| language | English |
| last_indexed | 2024-12-19T15:41:01Z |
| publishDate | 2021-07-01 |
| publisher | Surgical Society of Kenya |
| record_format | Article |
| series | The Annals of African Surgery |
| spelling | doaj.art-02465435b7cc4bd896c6c249077deedb2022-12-21T20:15:28ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162021-07-01183155162http://dx.doi.org/10.4314/aas.v18i3.6Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain InjuryPhilip Mwachaka0Angela Amayo1Nimrod Mwang’ombe2Peter Kitunguu3Department of Surgery, Neurosurgery Unit, University of Nairobi, Nairobi, Kenya; Department of Human Anatomy, University of Nairobi, Kenya.Department of Pathology, University of Nairobi, Nairobi, Kenya.Department of Surgery, Neurosurgery Unit, University of Nairobi, Nairobi, KenyaDepartment of Surgery, Neurosurgery Unit, University of Nairobi, Nairobi, KenyaBackground: Secondary brain insults after traumatic brain injury such as electrolyte dysfunctions are associated with poor outcomes. This study aimed at determining the incidence of serum sodium ion abnormalities and their association with clinico-radiological parameters. Methods: A prospective cross-sectional study of one hundred and seventeen patients with severe head injury. Data collected included patient demographics, prehospital interventions, clinical examination findings, computed tomography (CT) scan head findings, serum sodium ion levels (at admission and 48 h later), and outcome (30 days). Results: At admission, 93(79.5%) patients had normal serum sodium ion levels. However, 48 h post-admission, hypernatremia was prevalent in 56(63.6%) patients (p < 0.001). Hypernatremia was significantly associated with the use of mannitol (p = 0.036), lower Glasgow Coma Score (p = 0.047), higher Injury Severity Score (p = 0.015), presence of subdural hematoma (p = 0.044), midline shift >5 mm (p = 0.048), compressed/absent basal cistern (p = 0.010), and higher Rotterdam CT Score (p = 0.003). Hypernatremia reported 48 h post-admission was associated with a high 30-day mortality rate [odds ratio (OR) 3.55, p = 0.0095]. Risk of mortality associated with hyponatremia and hypernatremia at admission was not statistically significant. Conclusion: While both hyponatremia and hypernatremia can occur in serious TBI patients, hypernatremia predominates 48 hours post-admission and is associated with statistically significant increased risk of death.https://www.annalsofafricansurgery.com/sodium-severe-brain-injurytraumatic brain injuryhyponatremiahypernatremiaoutcomesclinico-radiologic parameters |
| spellingShingle | Philip Mwachaka Angela Amayo Nimrod Mwang’ombe Peter Kitunguu Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury The Annals of African Surgery traumatic brain injury hyponatremia hypernatremia outcomes clinico-radiologic parameters |
| title | Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury |
| title_full | Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury |
| title_fullStr | Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury |
| title_full_unstemmed | Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury |
| title_short | Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury |
| title_sort | association between serum sodium abnormalities and clinico radiologic parameters in severe traumatic brain injury |
| topic | traumatic brain injury hyponatremia hypernatremia outcomes clinico-radiologic parameters |
| url | https://www.annalsofafricansurgery.com/sodium-severe-brain-injury |
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