Abstract
Introduction
Patients with traumatic brain injury (TBI) are more vulnerable to develop hypokalaemia,
we sought to investigate the prevalence, and the relationship between severe hypokalaemia
and the mortality of traumatic brain injury patients.
Methods
Isolated traumatic brain patients who had hypokalaemia (serum potassium <3.5 mmol/L) and age ≥ 14 yrs were recruited into the study between January 2008 and March 2013. Hypokalaemia
was defined as potassium level in the blood <3.5 mmol/L during the hospitalisation, which was classified by severity: mild (3.0 mmol/L ≤ K < 3.5 mmol/L), moderate (2.5 mmol/L ≤ K < 3.0 mmol/L) and severe (K < 2.5 mmol/L). Multivariable logistic regression was performed to find the impact of hypokalaemia
on mortality.
Results
A total 375 cases were included in analysis. The peak incidence of severe hypokalaemia
occurred in the first 24–96 h. TBI patients with severe hypokalaemia had significantly higher serum sodium and
lower serum phosphorus than those patients with mild or moderate hypokalaemia (p < 0.001). Compare to other groups, the severe hypokalaemia group had the worst outcome.
Moreover, the patients (n = 15) who had severe hypokalaemia, hypernatraemia (Na > 160 mmol/L), and hypophosphataemia (P < 0.3 mmol/L) all died in hospital. Multiple logistic regression analysis resulted in decrease
of GCS (OR = 1.27; 95% CI = 1.15–1.41; p < 0.001) and potassium (OR = 4.35; 95% CI = 2.04–9.26; p < 0.001) being associated with significant increased risk of mortality.
Conclusions
The peak incidence of severe hypokalaemia occurred in the first 24–96 h. TBI patients with severe hypokalaemia are more vulnerable to develop hypophosphataemia
and hypernatraemia than patients with mild and moderate hypokalaemia. Severe hypokalaemia
are the independent risk factors for mortality in TBI patients.
Keywords
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Article info
Publication history
Published online: August 09, 2014
Accepted:
August 3,
2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
