# Frequency of Dysnatremia in the First 24 Hours and Its Relationship with Mortality in Patients with Severe Brain Trauma: Dysnatremia and Head Trauma

## TL;DR

This study finds that 44.5% of severe brain trauma patients experience dysnatremia in the first 24 hours, but it is not linked to higher mortality.

## Contribution

The study reports the frequency of dysnatremia in severe brain trauma patients and evaluates its association with mortality.

## Key findings

- Dysnatremia occurred in 44.5% of patients but was not significantly linked to mortality.
- Higher blood sugar levels were found to predict increased mortality risk in these patients.
- Diastolic blood pressure was higher in deceased patients compared to survivors.

## Abstract

Background: Dysnatremia (hypernatremia and hyponatremia) is known to make
hospitalized traumatic brain injury (TBI) patients vulnerable to morbidity
and mortality. This investigation aimed at observing frequency of
dysnatremia in the first 24 hours and its relationship with mortality in
patients with traumatic brain injuries.

Materials and Methods: This prospective descriptive-analytical study was
conducted at Hashminejad Hospital in Mashhad from April 2023 to March 2024.
The study sample included patients with severe traumatic brain injuries who
referred to the emergency room of Hashminejad Hospital in Mashhad.
Information about each patient, including age, sex, Glasgow coma score,
blood pressure, plasma sodium, creatinine, serum sugar, calcium, potassium,
blood urea nitrogen, and blood pressure at the beginning of admission.
Mortality was checked up to 48 hours.

Results: A total of 81 patients with traumatic brain injuries, with an
average age of 40.33 ± 19.47 years were included in the study; 85% were male
and 15% were female. 32 patients (40%) died and the rest were discharged.
Out of a total of 81 patients included in the study, 36 (44.5%) suffered
from dysnatremia. 16 patients (19.8%) had hyponatremia and 20 (24.7%) had
hypernatremia. The statistical results did not show any significant
relationship between the sodium status of patients and their outcome. In the
next step, statistical analysis showed that the patient’s sodium level
during hospitalization is not a predictor of mortality. Diastolic blood
pressure and blood sugar in deceased patients were substantially higher than
alive patients. The results showed that the only factor that could
substantially predict the death of patients was blood sugar, so that every
incremental rise in glucose level increased the chance of death by 1.018
times.

Conclusion: The present study showed that although dysnatremia has no
significant relationship with the outcome of brain trauma patients, it needs
attention due to its high incidence rate (44.5%) in these patients. In
addition, blood sugar was introduced as a factor that could predict the
death of patients.