Neurosurgerical Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University Medical School, PR China.
Injury. 2013 Sep;44(9):1213-8. doi: 10.1016/j.injury.2012.05.021. Epub 2012 Jun 17.
To investigate the relationship between severity of hypernatremia and the risk of death for patients with traumatic brain injury (TBI) who have been admitted to the neurosurgical intensive care unit (NICU).
A total of 1044 patients with TBI were admitted to our NICU from January 2005 to January 2010. Of these patients, 881 were included in this study. Based on blood serum sodium level in the NICU the 881 patients were divided into four groups: 614 had normal serum sodium (Na<150mmol/L), 34 had mild hypernatremia (Na 150-<155mmol/L), 66 had moderate hypernatremia (Na 155-160mmol/L) and 167 had severe hypernatremia (Na≥160mmol/L).
The mortality rates for the mild, moderate, and severe hypernatremia groups were 20.6%, 42.4%, and 86.8%, respectively; the mortality rate for the normal group was 2.0%. In multivariable analysis, mild, moderate, and severe hypernatremia were independent risk factors for mortality; compared with the normal group the odds ratios of mild, moderate, and severe hypernatremia were 9.50, 4.34, and 29.35, respectively.
Severe hypernatremia is an independent risk factor with extremely high odds ratio for death in patients with TBI who are admitted to the NICU.
探讨入住神经外科重症监护病房（NICU）的创伤性脑损伤（TBI）患者高钠血症严重程度与死亡风险的关系。
2005 年 1 月至 2010 年 1 月期间，共有 1044 例 TBI 患者入住我院 NICU，其中 881 例患者纳入本研究。根据 NICU 时的血清钠水平，881 例患者分为 4 组：614 例患者血清钠正常（Na<150mmol/L），34 例患者为轻度高钠血症（Na 150-<155mmol/L），66 例患者为中度高钠血症（Na 155-160mmol/L），167 例患者为重度高钠血症（Na≥160mmol/L）。
轻度、中度和重度高钠血症组的死亡率分别为 20.6%、42.4%和 86.8%，正常组的死亡率为 2.0%。多变量分析显示，轻度、中度和重度高钠血症均为死亡的独立危险因素；与正常组相比，轻度、中度和重度高钠血症的比值比分别为 9.50、4.34 和 29.35。
对于入住 NICU 的 TBI 患者，重度高钠血症是死亡的独立危险因素，其比值比极高。
