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

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.