title: Impact of electrolyte imbalances on the outcome of aneurysmal subarachnoid hemorrhage: A prospective study.
abstract: BACKGROUND
  Electrolyte disturbances are frequently observed during the acute and subacute period after subarachnoid hemorrhage (SAH) and may potentially worsen therapeutic outcome. This study was conducted to determine the pattern of electrolyte disturbance in the acute and subacute phase after SAH and their effect on the long-term outcome of the patients.
  
  
  METHODS
  Fifty-three patients were prospectively enrolled. The standards of care for all patients were uniformly performed. The serum levels of electrolytes (sodium, potassium and magnesium) were determined with measurements obtained on admission, 3-5 and 7-10 days after SAH. Radiographic intensity of hemorrhage (Fisher's scale), and the clinical grading (World Federation of Neurosurgical Societies grade) were documented in the first visit. The outcomes were evaluated using Glasgow outcome scale at 3 months after discharge.
  
  
  RESULTS
  Hyponatremia was the most common electrolyte imbalance among the patients but did not worsen the outcome. Although less common, hypernatremia in the subacute phase was significantly associated with poor outcome. Both hypokalemia and hypomagnesemia were predictive of poor outcomes.
  
  
  CONCLUSIONS
  Because electrolyte abnormalities can adversely affect the outcome, the serum levels of electrolytes should be closely monitored with serial measurements and treated properly in patients with aneurysmal SAH.
authors.affiliation: Brain and Spinal Injury Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maysam
authors.initials: M
authors.lastname: Alimohamadi
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Saghafinia
authors.affiliation: Brain and Spinal Injury Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Alikhani
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Danial
authors.affiliation: Brain and Spinal Injury Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Shirani
authors.affiliation: Brain and Spinal Injury Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Amirjamshidi
keywords: Aneurysm; electrolyte imbalance; outcome; subarachnoid hemorrhage