To evaluate the clinical and neuroradiological characteristics of dysnatremia in patients with traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality, presenting symptoms from seizures to speech disorders. Effective management of TBI typically involves stabilization, neuroimaging, and correction of metabolic imbalances such as dysnatremia, which can negatively impact patient outcomes.

A multicenter retrospective cohort study in three Guayaquil hospitals analyzed 200 ICU patients with acute traumatic brain injury from 2018 to 2023. Serum sodium levels were measured at admission and 48 hours post-admission, with data collected from clinical histories and neuroimaging. Statistical analyses included Chi-square, Kruskal-Wallis, Pearson correlation, and logistic regression.

Among the 200 patients, 85.5% were male, with higher alcohol consumption observed in those with dysnatremia (p=0.010). Hypernatremic patients exhibited lower Glasgow Coma Scale (GCS) and FOUR Scale scores at admission and 48 hours (p<0.001). Hypernatremia was associated with increased ventilatory support (94.5%) and higher mortality (41.8%) (p=0.017). Neuroimaging revealed links between hypernatremia and subarachnoid hemorrhage, cerebral edema, and contusions (p<0.05). Logistic regression indicated that higher GCS scores correlated with reduced mortality (OR=0.717, p<0.001).

Hypernatremia is significantly linked to severe neurological impairment, increased ventilatory support, and higher mortality in TBI patients. Early detection and correction of dysnatremia, aided by neuroimaging, may improve outcomes. Further studies are necessary to validate these findings and refine management protocols for dysnatremia in TBI.