Hypochloremia in Patients with Severe Traumatic Brain Injury: A Possible Risk Factor for Increased Mortality

Abstract

Objective: To determine association between electrolyte disturbances and mortality in patients with severe traumatic brain injury.

Methods: Medical records of patients with severe traumatic brain injury and Glasgow Coma Scale score <8 and electrolyte alterations were reviewed in a retrospective cohort study. Electrolyte levels were analyzed to establish an association between patients who died and patients who survived. Bivariate analysis was performed using χ² test with a statistical reliability of 95% for categorical variables. Analysis for electrolyte changes to determine association with mortality was performed using χ² test with multiple comparisons. Logistic regression was performed between the electrolyte alterations and their association with mortality. The reliability of statistical tests was 95%.

Results: There was a significant relationship between hypochloremia and increased risk of mortality in 23.1% of deceased patients (P = 0.03). Furthermore, there was a significant correlation with age (P < 0.01) and with the Acute Physiology and Chronic Health Evaluation APACHE II (P < 0.01).

Conclusions: Hypochloremia could be an important prognostic factor to determine mortality risk and to improve treatment in patients with severe traumatic brain injury.

Keywords: Mortality; Risk factor; Traumatic brain injury.