Browsing by Author "Sandra Nabukalu"

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    Factors associated with serum electrolyte imbalances and unfavorable Outcome among Traumatic Brain injury Patients at Mbarara Regional Referral Hospital
    (Kampala International University, 2023-05) Sandra Nabukalu
    Introduction: Electrolyte abnormalities have for long been a common observation among patients with brain lesions. Traumatic brain injury (TBI) is an important global public health concern. TBI patients with abnormal serum electrolytes show a delay in healing, increase in length of hospital stay (LOS) and a high mortality. Despite this, very few studies have been done on factors associated with this unfavorable outcome and none about electrolyte imbalances in Uganda. This study aimed at assessing the factors associated with serum electrolyte imbalances and unfavorable outcome among Traumatic Brain Injury patients at Mbarara Regional Referral Hospital (MRRH). Methods: This study was partly cross-sectional and partly prospective cohort done at MRRH. TBI Patients aged 18-65 years admitted at MRRH were enrolled. Serum electrolytes were measured at admission and 48 hours later. The patients were followed up to discharge and extended Glasgow outcome score determined in addition to LOS. Analysis was done using SPSS version 22. Results: During the study period, 254 patients with TBI were enrolled, majority of whom were males 226 (93.4%).Overall, 119(49.2%) patients had at least one electrolyte abnormality at one point during the study. The commonest electrolyte imbalances were hyponatremia and hyperchloremia. Hyponatremia at admission was independently associated with hyperthermia (AOR=2.531, CI=1.047-6.117, P=0.039) and being aged 46 years or above (AOR=2.784, CI= 1.006-7.706, P=0.049). Hypernatremia at admission was independently associated with being aged 45 years and (P=0.028, AOR=10.631, CI=1.288-67.747), Tachycardia at admission (P=0.011, AOR=14.642, CI=1.869-44.682) and hyperthermia at 48 hours (P=0.004, AOR=5.533, CI=1.321-18.620).Hyponatremia at 48 hours was independently associated with GCS < 13 at admission (AOR=3.671, CI=1.131-11.923, P=0.030).Hypernatremia at 48 hours was independently associated with age group 31-45 (P=0.023) and 46+ (P=0.027), bradycardia (P=0.019) and tachycardia (P=0.044) at admission, Low SPO2 at admission (p=0.001), Low SPO2 at 48 hours (P=0.014) and GCS 9-12 at 48 hours (P=0.025).Hypokalemia at admission was independently associated with systolic hypotension at admission (AOR=9.050, CI=1.477- 55.458, P=0.017). Hyperkalemia at admission was independently associated with systolic hypotension at admission (AOR=18.557, CI=1.973-74.513, P=0.011). Hypokalemia at 48 hours was independently associated with presenting after 24 hours (AOR=4.854, CI=1.046-22.523, P=0.044). Hyperkalaemia at 48 hours was independently associated with hypotension at 48 hours (P=0.035). Hypochloremia at admission was independently associated with hyperthermia at admission (AOR=6.847, CI=2.407-19.479, P=<0.001).Hyperchloremia at admission was independently associated with chronic alcohol use (P=0.031), presence of hypotension at admission (P=0.005), and presence of hyperthermia at 48 hours (P=0.047).Hypochloremia at 48hours was independently associated with having a GCS