Hyponatremia as an Independent Indicator of Grave Prognosis in Patients with Spontaneous Intracerebral Haemorrhage

Abstract

Background: Hyponatremia an electrolytic imbalance is most commonly found in all types
of stroke patients especially in haemorrhagic stroke and is associated with increased
mortality. Stroke severity, comorbid conditions associated with hyponatremia and type of
haemorrhage worsens the morbidity and mortality.
Objective: To determine hyponatremia as an independent indicator of grave prognosis in
patients with spontaneous intra cerebral haemorrhage.
Methods: A cross sectional study of 100 patients of haemorrhagic stroke confirmed by CT
scan or MRI at SCB Medical College &Hospital, was done with ethical clearance. The risk
factors were evaluated for correlation with hyponatremia and mortality rate, The patients with
or without neurological deficits were followed for 2 months and hyponatremia as
independent risk factor was analysed by multivariable cox regression model.
Observations: Hyponatremia was found in 54% of cases and mortality rate 31% in
hyponatremic patients compared to 10% in non-hyponatremic patients. Hyponatremia as a
risk factor for mortality in stroke patients with RR 3.63 (2.008-6.594) p=0.0001. Odds ratio
of hospital death and 60 days death rate were 9.093(3.614-22.881) p=0.0001 and
7.368(0.768-70.7090 P=0.041. The hazards ratio for 60 days death rate related to
hyponatremia was 3.03(1.705-5.419) P= <0.001 and significant when compared to mortality
related to age, ICH score >1, comorbidity, rebleeding and normonatretremic patients.
Conclusion: Hyponatremia due to any cause influence the mortality rate and and an
independent predictor of prognosis in patients with haemorrhagic stroke. Correction of
hyponatremia along with other medications may decrease the death rate but not up to mark as desired.