Dysnatremias And Short-term Outcomes Among Patients With Acute Severe Cerebral Infarction

Objectives:To explore the incidence and impact of dysnatremias on admission among patients with acute severe cerebral infarction.Methods:In this retrospective study performed at the neurologic intensive care unit (NICU) in the first hospital of Jilin University, we included 265 patients with a diagnosis of acute severe cerebral infarction between January 2008 and December 2010(time of onset≤72 hours and Glasgow Coma Scores≤12). Data on serum sodium, serum potassium, random blood glucose, blood urea nitrogen, white blood cell, the percentage of neutrophils and platelet at admission, and fasting blood glucose, albumin, total cholesterol on the next day were collected. We also obtained the following data, including age, sex, history of previous illnesses, location of infarction, length of hospital stay, survival or death and complications. Hyponatremia and hypernatremia were defined as values of serum sodium less than 136mmol/l and above 146mmol/l. Based on serum sodium concentrations, all patients were divided into three groups:hyponatremia group, normal serum sodium group and hypernatremia group respectively. Analyzing the incidence of dysnatremias and comparing the in-hospital mortality among the three groups. Besides, we also compare the baseline factors, other biochemical data, Glasgow Coma Scores, respiratory failure and length of hospital stay.Results:Of 265 patients,65(24.53%) developed dysnatremias, including 47(17.73%) patients with hyponatremia and 18(6.79%) patients with hypernatremia. In hyponatremia group, the patients suffering from mild, moderate and severe grades was 42(15.85%), 3(1.13%) and 2(0.75%) respectively. And it was 13(4.91%),3(1.13%) and 2(0.75%) for hypernatremia group. Admission Glasgow Coma Scores and values of albumin of patients with dysnatremias (hypo-and hypernatremia) were both lower than the normal serum sodium group. The white blood cell values were higher in hypernatremia group than the normal serum sodium group. The in-hospital mortality of hypernatemia groups was 66.67% and higher than the other groups significantly, but there was no significant difference between the normal serum sodium and hyponatremia groups (P=0.153). There was no statistical significance on age, sex, past medical history, location of infarction, length of hospital stay and respiratory failure.Conclusions:Dysnatremias on admission developed in patients with acute severe cerebral infarction is mainly mild. And compared with hypernatremia, hyponatremia seems to be more common in our study. Patients suffering from hypernatremia and hyponatremia have a low level of albumin and Glasgow Coma Scores, and a more serious condition. It proves that the patients with hypernatremia have increased in-hospital mortality and poor outcomes than the other groups. But the impact of hyponatremia on outcomes hasn't been found.