The Clinical Characteristics Of Electrolyte Disturbance In Patients With Moderate And Severe Traumatic Brain Injury And Its Influence On Prognosis

Objective To investigate the clinical characteristics of electrolyte disturbance and its influence on the prognosis of traumatic brain injury(TBI)patients.Methods The clinical data of 162 patients with moderate and severe traumatic craniocerebral injury admitted to the Second Affiliated Hospital of Jiaxing University from June 2019 to June 2021 were collected,including gender,age,hypertension,diabetes,glasgow coma score on admission.GCS),pupil changes,intracranial pressure(ICP),traumatic epilepsy,traumatic cerebral infarction,intracranial infection,and electrolyte indices were followed up 6 months later to investigate the clinical characteristics of electrolyte disorder and analyze the influence of electrolyte disorder on prognosis.Results Among 162 patients with moderate and severe craniocerebral injury,30 cases(18.5%)had hyponatremia,with an average of 13 1.43±3.55 mmol/L,which occurred 10.1±3.2 days after injury.There were 56 cases of hypernatremia(34.6%),with an average of 154.12±8.07 mmol/L,which occurred 2.3±0.8 days after injury.Hypokalemia was found in 77 cases(47.5%),with an average of 3.06±0.32 mmol/L.The average occurrence was 1.8±0.7 days after injury.There were 3 cases of hyperkalemia(1.9%)with an average of 7.14±1.30 mmol/L,and the average occurrence was 5.3±2.2 days after injury.110 cases(67.9%)were hypocalcemia,the average level was 1.84±0.10 mmol/L,and the average occurrence was 1.5±0.6 days after injury.There were 0 cases of hypercalcemia.There were 99 cases of hypomagnesia(63.5%),the average level was 0.65±0.06mmol/L,and the average occurrence was 1.3±0.7 days after injury.Hypermagnesia was found in 17 cases(10.9%),with an average level of 1.22±0.42 mmol/L,and occurred in 1.9±0.9 days after injury.Univariate regression analysis showed that there were statistical differences in age,GCS score,pupil change,ICP,hypernatremia,hypocalcemia,hypernatremia combined with hypocalcemia,hypernatremia combined with hypomagnesemia,traumatic epilepsy and traumatic cerebral infarction(p<0.05).There were no significant differences in gender,hypertension,diabetes,hyponatremia,hyperkalemia,hypokalemia,hypermagnesia,hypomagnesia and intracranial infection(p>0.05).After adjusting for sex,age,GCS score,pupil change,ICP,epilepsy and cerebral infarction,multivariate Logistic analysis showed that there was no statistical difference between hypernatremia,hyponatremia and hypocalcemia,but there was statistical difference between hypernatremia combined with hypocalcemia and hypernatremia combined with hypomagnesia(p<0.05).Conclusion Electrolyte disturbance is common in patients with moderate and severe craniocerebral injury.The incidence of hypocalcemia is the highest,followed by hypomagnesemia,hypokalemia,hypernatremia,hyponatremia and hypermagnesia.Low calcium,low magnesium and low potassium generally occur in the early post-TBI period,hypernatremia occurs in the peak of ICP,and hyponatremia occurs in the late post-ICP period.Hypernatremia combined with hypocalcemia and hypernatremia combined with hypomagnesia were associated with prognosis.