Outcome of Hypernatremia in neurological/ neurosurgical patients: A retrospective analysis

Background: Hypernatremia is known to have high mortality and morbidity. However, in many of the studies it is not clear whether the Hypernatremia associated with brain death has been excluded or not. As including them and Glasgow coma score (GCS) 3 patients will spuriously give a very high mortality rate. In this study, we have evaluated the mortality of Hypernatremia patients after excluding the brain dead and of GCS 3 patients on the first day of Hypernatremia. Materials and Methods: All the neurological patients admitted to hospital and had Hypernatremia were included into the study. Brain dead and GCS of 3 patients on the first day of Hypernatremia were excluded. The demographic variables, clinical variables and outcome variables were collected from the case files retrospectively. Results: Totally, one hundred Hypernatremia patients were chosen for the study. Among them 14 patients were excluded because of GCS 3 or GCS data was not available on the day of Hypernatremia. The demographic variables were given in the table. There was 32%, 39% and 52% mortality in the mild, moderate and severe Hypernatremia patients respectively. The head injured patients had higher mortality in comparison to all other diagnoses (56% Vs 29.6%, P < 0.02). Conclusion: The mortality is very high even in mild cases of Hypernatremia. Very high mortality (52%) is seen, even after excluding the GCS 3 patients. Therefore it is very important to identify, treat and monitor aggressively these patients.