# Kalemia Significantly Influences Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI)

## TL;DR

This study shows that potassium levels strongly affect outcomes in patients with severe traumatic brain injury, suggesting that monitoring and managing these levels could improve prognosis.

## Contribution

The study identifies significant correlations between potassium levels and clinical outcomes in severe TBI patients, emphasizing the importance of potassium management.

## Key findings

- Potassium levels at ICU admission correlate with injury severity scores and Glasgow Coma Scale scores.
- Potassium levels at discharge are strongly linked to mortality and hospital length of stay.
- Extreme potassium imbalances are associated with worse clinical outcomes and higher mortality rates.

## Abstract

Objective: Potassium levels (KLs) influence clinical outcomes in severe traumatic brain injury (TBI). This study investigates the relationship between KLs and clinical outcomes to improve prognosis and guide management. Method: A retrospective study was conducted at a level 1 trauma center in Queens, New York, from January 2020 to December 2023. Patients with an AIS score of 3 or higher were included. KLs were measured at the time of hospital admission, ICU admission, ICU discharge, hospital discharge, and death, if applicable. Clinical outcomes such as age, race, length of hospital stay (H LOS), ICU length of stay (ICU LOS), ventilation days (VDs), Glasgow Coma Scale (GCS), and mortality were assessed. Results: KLs were categorized into five groups: extreme hypokalemia (<2.5 mEq/L), hypokalemia (2.6–3.5 mEq/L), normokalemia (3.5–5.2 mEq/L), hyperkalemia (5.2–7.0 mEq/L), and extreme hyperkalemia (>7.0 mEq/L). Significant correlations were observed between KLs at hospital admission and age (p = 0.0113), race (p = 0.003), and H LOS (p = 0.079). ICU KLs showed positive correlations with AIS head score (p = 0.038), ISS (p = 7.84 × 10−6), and GCS (p = 2.6 × 10−6). ICU KLs were also associated with LOS in the Emergency Department (ED) (p = 6.875 × 10−6) and ICU (p = 1.34 × 10−21), as well as VDs (p = 7.19 × 10−7). ICU discharge KLs correlated with ISS (p = 2.316 × 10−3), GCS (p = 2.201 × 10−3), ED LOS (p = 3.163 × 10−4), and VDs (p = 7.44 × 10−4). KLs at discharge were linked with mortality (p < 0.0001) and H LOS (p = 0.0091). Additionally, KLs at the time of death were correlated with ISS (p = 0.01965), GCS (p = 0.01219), ED LOS (p = 0.00594), ICU LOS (p = 0.049), VDs (p = 0.00005), and mortality (p < 0.0001). Conclusions: Potassium imbalances, especially hypokalemia, significantly affect outcomes in severe TBI patients. Monitoring and managing KLs may improve prognosis.