Cerebral Salt Wasting in Traumatic Brain Injury Is Associated with Increased Morbidity and Mortality

• Published in: Neuropsychiatric disease and treatment 2020-01, Vol.16, p.801-806
• Main Authors: Chendrasekhar, Akella, Chow, Priscilla T, Cohen, Douglas, Akella, Krishna, Vadali, Vinay, Bapatla, Alok, Patwari, Jakey, Rubinshteyn, Vladimir, Harris, Loren
• Format: Article
• Language: English
• Subjects: Age; Analysis; Brain injuries; Comparative literature; Data analysis; Head injuries; Hyponatremia; hypovolemia; Information management; Medical research; Morbidity; Mortality; natriuresis; Neurosurgery; Original Research; Patient outcomes; Patients; Salt; Salt industry; Setting (Literature); Side effects; Surgery; Survival; Time; Trauma; Traumatic brain injury; Variance analysis; Ventilators
• ISSN: 1176-6328; 1178-2021; 1178-2021
• DOI: 10.2147/NDT.S233389

In the setting of cerebral injury, cerebral salt wasting (CSW) is a potential cause of hyponatremia, which contributes to adverse effects and mortality. The primary objective of this study was to evaluate the clinical outcomes of severe traumatic brain injury (TBI) patients complicated by CSW. A retrospective data analysis was performed on data collected from patients with TBI with an abbreviated injury scale (AIS) greater than 3. Data was divided into 2 groups of patients with CSW and those without. The primary endpoint was incidence of adverse effects of CSW in regard to injury severity score (ISS), hospital length of stay (HLOS), ventilator days, ICU length of stay (ICU LOS) and survival to discharge. Data was analyzed using a one-way analysis of variance (ANOVA). A total of 310 consecutive patients with severe head injury (anatomic injury score 3 or greater) were evaluated over a 3-year period. A total of 125 of the 310 patients (40%) were diagnosed with cerebral salt wasting as defined by hyponatremia with appropriate urinary output and salt replacement. Patients with CSW had poorer outcomes in regard to ISS (21.8 vs 14.2, p