Association Between Serum Sodium Abnormalities and Clinico-radiologic Parameters in Severe Traumatic Brain Injury

Philip Mwachaka1,2, Angela Amayo3, Nimrod Mwang’ombe1, Peter Kitunguu1
1Department of Surgery, Neurosurgery Unit, University of Nairobi, Nairobi, Kenya.
2Department of Human Anatomy, University of Nairobi, Kenya.
3Department of Pathology, University of Nairobi, Nairobi, Kenya.

Correspondence to: Dr. Philip Mwachaka; Email: pmaseghe@gmail.com

Received: 16 June 2020; Revised: 13 October 2020; Accepted: 9th January 2021; Available online: 3rd March 2021

Abstract

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.

Keywords: Traumatic brain injury, hyponatremia, hypernatremia, outcomes, clinico-radiologic parameters

DOI: http://dx.doi.org/10.4314/aas.v18i2.4

Conflicts of Interest: None

Funding: None

© 2021 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

ssk_logo.png

The Annals of African Surgery is the official publication of the Surgical Society of Kenya.

 

All content copyright © 2021 Annals of African Surgery.

ISSN (print): 1999-9674; ISSN (online): 2523-0816

Main Office Location: Menelik Medical Centre, Menelik Road, off Ngong Road, Nairobi. First floor.

Telephone: +254715260499

Email: info@annalsofafricansurgery.com.

 

The content on this site is intended for health professionals. Advertisements on this site do not constitute a guarantee or endorsement by the journal, Association, or publisher of the quality or value of such product or of the claims made for it by its manufacturer.

Click here to subscribe and get the latest from Annals of African Surgery

Click here to apply as a Journal Reviewer!

70.png
69.jpg
hinari_header_en.png
  • Twitter
  • Facebook Social Icon
  • YouTube
  • LinkedIn
  • Instagram