Clinical study of water and electrolyte disturbance in patients with traumatic brain injury

Objective To investigate the characteristics and principles of water and electrolyte disturbance (WED) after traumatic brain injury and to provide evidence for its clinical diagnosis and treatment. Methods A total of 118 patients with traumatic brain injury were treated at Department of Neurosurgery, Nanfang Hospital, Southern Medical University between June 2015 and June 2016, and their data were analyzed retrospectively. The timing of occurrence of WED was studied. In addition, the associated factors of various types of WED and their relationship to prognoses were explored. Results There was no correlation between the degree of traumatic severity and the degree of hyponatremia (P=0.639), while the degree of traumatic severity had significant effects on the degrees of hypernatremia and hypokalemia (both P<0.05). Severe hyponatremia, hypernatremia and hypokalemia normally occurred within the first 1-2 days post injury. Among patients with different injured locations, the degrees of hyponatremia, hypernatremia and hypokalemia revealed statistical difference with each other (all P<0.05). The degrees of hypernatremia and hypokalemia had correlation with the GOS prognosis (both P<0.05). Conclusions After the traumatic brain injury, the severity of WED seems to be closely related to the degree and location of injury in the patient. Severer injury might be linked to increased risk of severe hypernatremia and hypokalemia rather than hyponatremia. Patients with frontal lobe damage and diffuse axonal injury could have a larger chance of developing WED. It is suggested that severe hypernatremia and hypokalemia occur early post injury and are closely related to the patient's prognosis. Key words: Craniocerebral trauma; Hyponatremia; Hypernatremia; Hypokalemia