Correlation of disturbance of electrolyte balance with outcome of disorders of consciousness in patients with primary brainstem hemorrhage

Abstract

Objective To investigate the characteristics of disturbance of electrolyte balance after primary brainstem hemorrhage (PBH) and their correlation with the outcome of patients with disorders of consciousness (DOC). Methods A retrospective survey was used to statistically analyze the clinical data of 350 patients with brainstem hemorrhage admitted to the Second Affiliated Hospital of Army Military Medical University from January 1, 2010 to September 1, 2020. With our strict inclusion and exclusion criteria, 47 PBH cases undergoing standardized fluid replacement were screened out. Then they were divided into the non-DOC group (n=21), DOC group (n=21) and DOC translating to non-DOC group (n=5) according to their state of consciousness. The quantities of venous blood electrolyte and carbon dioxide during the whole duration of hospital stay were collected, and then analyzed for the changes of sodium, potassium, chloride, anion gap (AG) and CO2. Next, we analyzed the rule and characteristics of the changes of mean value, maximum value, minimum value, abnormal rate, average fluctuation range and other indicators, and explored their relationship with PBH. Results One-way analysis of variance (ANOVA) showed that there were significant differences in the mean value, maximum value, minimum value, abnormal rate and average fluctuation range of chloride ion and AG among the 3 groups (P < 0.05). But in addition to the abnormal rate and average fluctuation range of CO2 content, there were no statistical differences in the contents of sodium ion, potassium ion and CO2 among the 3 groups. Further multiple intra-group comparative analysis indicated that the mean value, maximum value, abnormal rate and average fluctuation range of chloride ion and AG were significantly increased, while the minimum value was decreased in the DOC group than the non-DOC group (P < 0.01). The abnormal rate and average fluctuation range of potassium ion, AG and CO2 content were significantly increased (P < 0.01), but no statistical significance was seen in sodium and chloride in the DOC translating to non-DOC group than the non-DOC group. Conclusion The disturbance of electrolyte balance is closely associated with the DOC severity in PBH patients. The higher the abnormal rate of chloride ion and AG and the average fluctuation range are, the more severe DOC is.

Keywords

• primary brainstem hemorrhage
• disorders of consciousness
• disturbance of electrolyte balance
• outcome
• chloride ion
• anion gap