Study of Serum Sodium Levels In Traumatic Brain Injury (TBI)

Introduction: Serum sodium levels change after traumatic brain injury effecting the outcome in terms of morbidity and mortality that can occur depending upon the severity of the disturbance of sodium levels. This study is an effort to evaluate the association between serum sodium levels in TBI patients and the clinical outcome.

Objectives: To study the serum sodium levels and outcome of management in TBI
Study design: Observational cross sectional retrospective study.

Methods: Patients admitted in Neuro surgery ICU with a diagnosis of Traumatic Brain Injury from 1st July 2018 till 30th June 2020 were evaluated. Patients were classified as mild, moderate and severe head injury based on GCS and their Serum sodium levels were recorded at the time of admission and their clinical outcome using GOS score was studied.

Results: There were 533 patients with 440(82.6%) males and 93( 17.4%) females. Sodium was normal in 355 (66.6%) patients, with moderate hyponatremia in 9(1.7%) patients. Mild Hyponatremia in 160 (30%) of patients. Hypernatremia was noted in 9(1.7%) of total patients. The Majority of patients had Mild Head Injury 366 (68.7%), Moderate Head Injury 75(14.1%), severe head injury (17.3%) Moderate disability with GOS 4 in majority 452(84.8%) of people with Good recovery in 40(7.5%), Severe disability in 12 (2.3%0, Neurovegetative state 7(1.3%), Dead 22(4.1%) of all the patients recruited in the study. There was significant statistical relationship between the serum sodium value and the GOS outcome (P <=0.008)

Conclusion : Serum Sodium is an important prognostic marker of clinical outcome of patients with traumatic brain injury and needs to be monitored and corrected if abnormal in all patients with TBI to improve their outcomes.

Key words: serum sodium levels, TBI, Outcome