Assess the impact of sodium levels on in-patient mortality among Hispanic patients with traumatic brain injury (TBI) within the first 72 hours post-injury.

Dysnatremia is a common and significant electrolyte disturbance in TBI patients, often leading to severe complications that worsen neurological outcomes and increase mortality rates. Abnormal sodium levels can adversely affect cerebral perfusion and exacerbate brain injury, complicating clinical management. While the influence of sodium levels on outcomes has been documented across various populations, the specific effects of dysnatremia on mortality among Hispanic patients remain inadequately defined.

We conducted a multicenter, retrospective study involving Hispanic patients with TBI from three trauma centers in Ecuador. Data were collected from medical records, including comorbidities (diabetes, hypertension, alcohol, and drug use), scales (Glasgow Coma Scale (GCS), Four Scale, and Marshall Scale), sodium levels at 24, 48, and 72 hours post-injury, as well as the average sodium level during this period. Logistic regression was performed, including covariates, and bootstrap resampling (10,000 iterations) validated the model.

Among 200 patients (85.5% male, mean age 37±19 years, mean GCS upon admission 10±4), the average sodium level within the first 72 hours post-injury was 141±6 mEq/L. Elevated average sodium levels during this period were significantly associated with mortality. After adjusting for demographics, comorbidities, and neurological scales, the average sodium level remained a significant predictor of mortality (OR 1.39, 95% CI 1.04–1.85, p = 0.025). Bootstrap validation confirmed the robustness of these findings, achieving an overall accuracy of 77.8% with a Nagelkerke R² of 0.184.

Elevated average sodium levels within 72 hours of injury are linked to increased mortality in Hispanic patients with TBI. These insights emphasize the need for clinicians to prioritize sodium monitoring and intervention in the acute management of TBI, ultimately aiming to enhance survival outcomes for affected patients.