Kalemia Significantly Influences the Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI)

Objective: Potassium levels (KL) influence clinical outcomes in severe traumatic brain injury (TBI). This study investigates the relationship between potassium levels and clinical outcomes to improve prognosis and guide management. Method: A retrospective study was conducted at a level 1 trauma center in Queens, New York, from January 2020 to December 2023. Patients with an AIS score of 3 or higher were included. Potassium levels were measured at the time of hospital admission, ICU admission, ICU discharge, hospital discharge, and death, if applicable. Clinical outcomes such as age, race, length of hospital stay (HLOS), ICU length of stay (ICU LOS), ventilation days (VD), Glasgow Coma Scale (GCS), and mortality were assessed. Results: Potassium levels were categorized into five groups: extreme hypokalemia (< 2.5 mEq/L), hypokalemia (2.6–3.5 mEq/L), normokalemia (3.5–5.2 mEq/L), hyperkalemia (5.2–7.0 mEq/L), and extreme hyperkalemia (>7.0 mEq/L). Significant correlations were observed between potassium levels at hospital admission and age (p = 0.0113), race (p = 0.003), and HLOS (p = 0.079). ICU potassium levels showed positive correlations with AIS head score (p = 0.038), ISS (p = 7.84E−6), and GCS (p = 2.6E−6). ICU potassium levels were also associated with length of stay in the Emergency Department (ED) (p = 6.8749E−6) and ICU (p = 1.34E−21), as well as ventilation days (p = 7.19E−7). ICU discharge potassium levels correlated with ISS (p = 2.316E−3), GCS (p = 2.2009E−3), ED LOS (p = 3.163E−4), and ventilation days (p = 7.43971E−4). Potassium levels at discharge were linked with mortality (p < 0.0001) and HLOS (p = 0.0091). Additionally, potassium levels at the time of death were correlated with ISS (p = 0.01965), GCS (p = 0.01219), ED LOS (p = 0.00594), ICU LOS (p = 0.049), ventilation days (p = 0.00005), and mortality (p < 0.0001). Conclusion: Potassium imbalances, especially hypokalemia, significantly affect outcomes in severe TBI patients. Monitoring and managing potassium levels may improve prognosis.