Evaluation of Serum Electrolyte Abnormalities in Patients With Severe Head Injury at The kenyatta National Hospital in Kenya

Abstract

(p=0,024). At the same time, increased pulse rate (p=0.007) and traumatic SAH (p=0.045) were observed in patients with hyperkalemia. Mortality risk associated with hypokalemia was significantly increased OR 4.12 (95% CI: 1.14-14.83, p=0.031) and OR 5.12 (95% CI: 1.08-24.25, p=0.039) at admission and 48 hours post-admission, respectively. 3 Hypocalcemia was the most common calcium ion abnormality reported in 84 (72.4%) patients on admission and in 34 (37.8%) patients 48 hours after admission. Patients with hypocalcemia were significantly older (p=0.044), with higher HCO3 (p=0.039) and base deficits (p=0.048). Patient age, injury severity score, heart rate, and systolic blood pressure reported statistically significant negative correlations with calcium ion levels. Hypocalcemia noted 48hrs after admission was associated with a high risk of mortality (OR 5.70, 95 % CI 1.15-28.33, p=0.033) compared to that at admission (OR 3.2, 95 % CI: 0.52-19.84, p=0.212). Hypomagnesemia was the most common magnesium ion abnormality reported in 36 (33.3%) and 30 (34.5%) of admission and 48 hours post-admission cases, respectively. Mortality risk associated with hypomagnesemia at admission and 48 hours post-admission was OR 2.4 (95% CI: 0.39-14.88, p=0.35) and OR 0.3 (95% CI: 0.03 to 2.69, p=0.27) respectively. Patient age and systolic BP showed a significant negative correlation with magnesium ion levels. None of the radiological or acid-based parameters showed significant correlations. Hypophosphatemia was the predominant phosphate ion abnormality, noted in 40(42.1%) and 29(48.3%) of the cases at admission and 48hrs post-admission respectively. Low levels of phosphate were significantly correlated with pre-hospital use of IV fluids (p=0.041), mannitol use (p=0.048), lower diastolic pressure (p=0.043), tachypnoea (p=0.044), hypoxemia (p=0.011) and respiratory alkalosis (p<0.001). Hypophosphatemia was associated with a high risk of mortality; OR 4.12 (95% CI: 1.14-14.83, p=0.031) at admission and OR 7.5 (95% CI: 1.08-90.24, p=0.098) 48 hours post-admission. Conclusion: Serum sodium, potassium, calcium, magnesium and phosphate ion abnormalities are common in severe traumatic brain injury patients in our setting. They are associated with higher 4 risk of mortality and can be expected to occur in patients with abnormalities in specific clinical, radiological and acid-based parameters. 5 es (10–12). In order to improve outcomes for patients with TBI