Ziaei Maryam, Galavi Mehdi, Bahmani Alireza, Abdolrazaghnejad Ali
Department of Emergency Medicine, Khatam-Al-Anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
Department of Emergency Medicine, Ali Ibn Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
Adv Biomed Res. 2023 Feb 25;12:40. doi: 10.4103/abr.abr_393_21. eCollection 2023.
Traumatic brain injury (TBI) is a leading cause of death among patients in developed countries. The patients' prognosis depends on the trauma-induced primary damage as well as the secondary brain damage, including electrolyte disturbances. Therefore, prevention, diagnosis, and timely treatment lead to better prognosis. Herein, the aim is to prognosticate about the mortality in patients with TBI through serum osmolarity at admission.
In this cross-sectional study, 141 patients with TBI were assigned through convenience sampling. The level of serum osmolarity was examined once the patients were admitted to emergency department and later, the outcome was recorded. Finally, we analyzed the relationship between osmolarity level and patient outcome in age groups.
The mean serum osmolarity in the age group of under 18 years, 18 to 60 years, and more than 60 years was equal to 295.3 ± 10.02 mOsm/L, 297.2 ± 6.5 mOsm/L, and 301.6 ± 7.6 mOsm/L, respectively (-value <0.001). Osmolarity with a cut-off point of more than 298.90 and sensitivity and specificity of 70.49 and 62.86, respectively, had appropriate diagnostic value for predicting mortality in these patients (-value <0.001).
According to the results of this study, serum osmolarity can have an appropriate diagnostic value in predicting mortality in patients with TBI. In addition, in different age categories, the osmolarity serum in the mortality of these patients was significantly different. Therefore, due to the high importance of serum osmolarity in the mortality of patients, careful monitoring of fluid therapy status of trauma patients should be implemented to prevent the development of hyperosmolarity for the patient with irreversible outcomes.
创伤性脑损伤（TBI）是发达国家患者死亡的主要原因。患者的预后取决于创伤引起的原发性损伤以及继发性脑损伤，包括电解质紊乱。因此，预防、诊断和及时治疗可带来更好的预后。在此，目的是通过入院时的血清渗透压预测TBI患者的死亡率。
在这项横断面研究中，通过便利抽样分配了141例TBI患者。患者入院急诊科后检查血清渗透压水平，随后记录结果。最后，我们分析了年龄组中渗透压水平与患者预后之间的关系。
18岁以下、18至60岁和60岁以上年龄组的平均血清渗透压分别等于295.3±10.02 mOsm/L、297.2±6.5 mOsm/L和301.6±7.6 mOsm/L（P值<0.001）。渗透压截断点大于298.90，敏感性和特异性分别为70.49和62.86，对预测这些患者的死亡率具有适当的诊断价值（P值<0.001）。
根据本研究结果，血清渗透压在预测TBI患者死亡率方面可具有适当诊断价值。此外，在不同年龄类别中，这些患者死亡率中的血清渗透压存在显著差异。因此，由于血清渗透压在患者死亡率方面的高度重要性，应仔细监测创伤患者的液体治疗状态，以防止不可逆结局患者出现高渗状态。
