Morbidity and mortality associated with hypernatremia in patients with severe traumatic brain injury

Neurosurgical Focus
Aditya VedantamShankar P Gopinath

Abstract

OBJECTIVE Hypernatremia is independently associated with increased mortality in critically ill patients. Few studies have evaluated the impact of hypernatremia on early mortality in patients with severe traumatic brain injury (TBI) treated in a neurocritical care unit. METHODS A retrospective review of patients with severe TBI (admission Glasgow Coma Scale score ≤ 8) treated in a single neurocritical care unit between 1986 and 2012 was performed. Patients with at least 3 serum sodium values were selected for the study. Patients with diabetes insipidus and those with hypernatremia on admission were excluded. The highest serum sodium level during the hospital stay was recorded, and hypernatremia was classified as none (≤ 150 mEq/L), mild (151-155 mEq/L), moderate (156-160 mEq/L), and severe (> 160 mEq/L). Multivariate Cox regression analysis was performed to determine independent predictors of early mortality. RESULTS A total of 588 patients with severe TBI were studied. The median number of serum sodium measurements for patients in this study was 17 (range 3-190). No hypernatremia was seen in 371 patients (63.1%), mild hypernatremia in 77 patients (13.1%), moderate hypernatremia in 50 patients (8.5%), and severe hypernatremia in...Continue Reading

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Citations

Mar 15, 2018·The Journal of Trauma and Acute Care Surgery·Jonathan V MartinLawrence N Diebel
Jul 18, 2018·Current Opinion in Anaesthesiology·Boris D HeifetsMark A Burbridge
Feb 16, 2019·Journal of Neurosciences in Rural Practice·Joshua B BrownJuan Carlos Puyana
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Nov 2, 2019·Neurosurgical Focus·Fatima KhalidJohn N Lorenz

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.