Evaluation of Electrolyte Imbalance in Patients With Traumatic Brain Injury Admitted in the Central ICU of a Tertiary Care Centre: A Prospective Observational Study

Dey, Sandeep; Kumar, Ramesh; Tarat, Abhijit

doi:10.7759/cureus.17517

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…According to this definition, 30.7% and 2.1% of our included TBI patients developed hypomagnesemia (<1.7 mg/dL) and hypermagnesemia (>2.4 mg/dL), respectively. Previous research showed that the incidence of hypomagnesemia in TBI patients ranges from 42.7% to 66% [ 5 , 6 , 16 , 17 ]. The incidence variation may be attributable to the different definitions of hypomagnesemia and brain injury severity.…”

Section: Discussionmentioning

confidence: 99%

“…Electrolyte imbalance is a common complication caused by pathophysiological changes or medical treatments after suffering head trauma. Previous studies have shown that the incidence of electrolyte imbalance ranges from 21% to 82% in TBI patients [ 4 , 5 , 6 ]. Additionally, several kinds of electrolyte imbalance increase the risk of poor outcomes in TBI, such as hypernatremia and acidosis [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have verified hypomagnesemia as a risk factor for poor prognosis in some neuro-intensive patients, such as ischemic stroke and intracerebral hemorrhage [ 11 , 12 , 13 , 14 , 15 ]. As for TBI patients, several studies indicate that hypomagnesemia occurs, with the incidence ranging from 42.7% to 66% [ 5 , 6 , 16 ]. At the same time, the definition of hypomagnesemia in these studies is not consistent, and the association between hypomagnesemia and the outcome of TBI patients has not reached an agreement [ 6 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…As for TBI patients, several studies indicate that hypomagnesemia occurs, with the incidence ranging from 42.7% to 66% [ 5 , 6 , 16 ]. At the same time, the definition of hypomagnesemia in these studies is not consistent, and the association between hypomagnesemia and the outcome of TBI patients has not reached an agreement [ 6 , 16 ]. Additionally, the correlation between serum magnesium level and risk of poor outcome in TBI may be nonlinear rather than linear, which indicates that hypermagnesemia may also be related to the prognosis of TBI patients.…”

Section: Introductionmentioning

confidence: 99%

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Initial Serum Magnesium Level Is Associated with Mortality Risk in Traumatic Brain Injury Patients

Wang

2022

Nutrients

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Background: Electrolyte disorder is prevalent in traumatic brain injury (TBI) patients. This study is designed to explore the association between initial serum magnesium levels and mortality of TBI patients. Methods: TBI patients recorded in the Medical Information Mart for Intensive Care-III database were screened for this study. Logistic regression analysis was used to explore risk factors for mortality of included TBI patients. The restricted cubic spline (RCS) was applied to fit the correlation between initial serum magnesium level and mortality of TBI. Results: The 30-day mortality of included TBI patients was 17.0%. Patients with first-tertile and third-tertile serum magnesium levels had higher mortality than those of the second tertile. Univariate regression analysis showed that the serum magnesium level was not associated with mortality. Unadjusted RCS indicated the relationship between serum magnesium level mortality was U-shaped. After adjusting confounding effects, multivariate regression analysis presented that serum magnesium level was positively associated with mortality. Conclusion: TBI patients with abnormally low or high levels of serum magnesium both have a higher incidence of mortality. At the same time, a higher initial serum magnesium level is independently associated with mortality in TBI patients. Physicians should pay attention to the clinical management of TBI patients, especially those with higher serum magnesium levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Initial Serum Magnesium Level Is Associated with Mortality Risk in Traumatic Brain Injury Patients

Wang

2022

Nutrients

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“…Previous research suggested that electrolyte levels can fluctuate during ICU stay. Hypocalcemia or hypomagnesemia, for example, often occurs from day 3 to day 5 and may persist for 2–3 weeks [ 26 ]. Finally, functional outcomes and cognitive status were not evaluated in this study as they fall outside the study scope.…”

Section: Limitationsmentioning

confidence: 99%

Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

et al. 2023

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Background: We sought to evaluate the predictor role of the initial serum level of calcium and magnesium in hospitalized traumatic brain injury (TBI) patients. Materials and methods: A retrospective analysis of all TBI patients admitted to the Hamad Trauma Center (HTC), between June 2016 and May 2021 was conducted. Initial serum electrolyte levels of TBI patients were obtained. A comparative analysis of clinical variables between patients with abnormal and normal serum electrolyte level was performed. Logistic regression analysis with the variables that showed a significant difference (p < 0.05) in the bivariate analysis was performed to calculate the odds ratios (OR) for mortality. Results: There was a total of 922 patients with clinical records of serum electrolyte levels at admission. Of these, 757 (82.1%) had hypocalcemia, 158 (17.1%) had normal calcium level, and 7 (0.8%) had hypercalcemia. On the other hand, 616 (66.8%) patients had normal magnesium level, 285 (30.9%) had hypomagnesemia, and 12 (1.3%) had hypermagnesemia. The mortality rate in hypocalcemia group was 24% while in patients with normal calcium level it was 12%, p = 0.001. Proportionate mortality rates in hypomagnesemia and normal magnesium groups were 15% and 23% (p = 0.006), respectively. On the other hand, 7 out of 12 (58%) hypermagnesemia patients died during the index hospitalization. The regression model including GCS, ISS, PT, aPTT, INR, Hemoglobin, Bicarbonate, Lactate, Sodium, Potassium, Calcium, Magnesium, and Phosphate showed that hypocalcemia was not a significant predictor [OR 0.59 (CI 95%: 0.20–1.35)] of mortality after TBI. However, hypermagnesemia was a significant predictor [OR 16 (CI 95%: 2.1–111)] in addition to the GCS, ISS, aPTT, Bicarbonate, and Lactate values on admission. Conclusion: Although hypocalcemia and hypomagnesemia are common in hospitalized TBI patients, hypocalcemia was not a significant predictor of mortality, while hypermagnesemia was an independent predictor. Further studies with larger sample size and with prospective design are required to support these findings and their importance.

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Effect of Serum Ionic Magnesium on Neurological Outcome in Severe Traumatic Brain Injury Patients: A Prospective Study

Bal,

Jain,

Acharya

et al. 2024

Indian Journal of Neurotrauma

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Background Magnesium is considered to have important role in cytotoxic and reperfusion pathways, deficiency of which may lead to secondary brain injuries; thus, hypomagnesemia is thought to be detrimental in traumatic brain injury (TBI) patients. The aim of this study was to evaluate the relationship between serum ionic magnesium level and neurological outcome in severe TBI patients. Materials and Methods Eighty-four patients with severe TBI aged between 20 and 80 years admitted within 24 hours of injury included in our study. All patients were divided into two categories on the basis of initial serum magnesium levels as low serum magnesium level and normal serum magnesium level. Data was collected on the basis of age, gender, Glasgow Coma Scale (GCS) at the time of admission, and neurological outcome evaluation done on the basis of Glasgow Outcome Scale (GOS) at the end of 6 months. Results Among the total patients, 32 patients had low serum magnesium level (< 1.6 mg/dL) at the time of admission. About 87.5% patients with low serum magnesium level had poor neurological outcome as compared to 12.5% of patients (p < 0.001) had good neurological outcome evaluated on the basis of GOS. Logistic regression model identified low Mg level (odds ratio = 6.593, p = 0.002) and GCS score less than 5 (odds ratio = 3.099, p = 0.028) as independent predictors of TBI. Conclusion Hypomagnesemia seems to be an independent prognostic marker in severe TBI that can lead to poorer outcomes.

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Evaluation of Electrolyte Imbalance in Patients With Traumatic Brain Injury Admitted in the Central ICU of a Tertiary Care Centre: A Prospective Observational Study

Cited by 7 publications

References 21 publications

Initial Serum Magnesium Level Is Associated with Mortality Risk in Traumatic Brain Injury Patients

Initial Serum Magnesium Level Is Associated with Mortality Risk in Traumatic Brain Injury Patients

Initial Serum Levels of Magnesium and Calcium as Predictors of Mortality in Traumatic Brain Injury Patients: A Retrospective Study

Effect of Serum Ionic Magnesium on Neurological Outcome in Severe Traumatic Brain Injury Patients: A Prospective Study

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