The relationship between cerebral salt wasting syndrome and clinical outcome in severe and moderate traumatic brain injury patient at sanglah hospital, Bali, Indonesia

Abstract

Introduction: Intracranial and extracranial factors causing secondary Traumatic Brain Injury (TBI) are the primary targets for medical intervention and preventing brain damage. One of the extracranial factors that worsen the prognosis of TBI is Cerebral Salt Wasting (CSW) syndrome. There are only a few articles that report CSW in TBI patients, and no studies are describing the relationship between CSW and clinical outcome of head injury. This study aimed to determine the relationship between CSW and clinical outcome of TBI patients. Methods: This was a prospective cohort study conducted from October 2018 to May 2019. Data collection was carried out in a surgical emergency and inpatient ward at Sanglah Hospital. The outcome was assessed using the Glasgow Outcome Scale (GOS) 3 months after head injury. The relationship between variables was analyzed and using Chi-square analysis. Data were analyzed using SPSS version 23 for Windows. Results: Most of respondents are male (83.3%), severe head injury (73.3%), mild hyponatremia (90.0%), and negative fluid balance (100.0%) in CSW (+) group (Table 1). However, in CSW (-) group, most of respondents are male (70.0%), moderate head injury (85.0%), normal serum natrium (80.0%), and positive fluid balance (60.0%). CSW increased the risk of unfavorable outcomes, 5.7 times in moderate and severe head injuries (95% CI=1.8 – 18.4; p=< 0.001). Conclusion: CSW syndrome increased the risk of unfavorable outcomes in moderate and severe traumatic brain injury patients.