الفهرس 
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Abstract
Traumatic brain injury (TBI) is a prevalent neurological condition. It significantly affects mental, physical, and cognitive functions and is a substantial cause of illness and mortality. Patients are more likely to experience abnormalities in serum sodium and ionized calcium. Effective therapy of electrolyte issues improves neurological disorders and reduces mortality. Therefore, we investigated the potential predictive significance of ionized hypocalcemia for early mortality in TBI patients.
The aim of the study was to investigate the predictive significance of ionized hypocalcemia in TBI patients.
Primary outcome: 28-day mortality rate in individuals with TBI and lower ionized calcium levels .
Secondary outcomes: neurological deficit and organ dysfunction in such patients.
Sixty adult patients with TBI of both sexes participated in this prospective observational study in the intensive care units, Ain Shams University hospitals. They were divided into control group (normocalcemic patients) and study group (ionized hypocalcemic patients).
Upon admission, medical history was taken , physical and neurological evaluation, and proper investigations including ionized calcium and sodium were done. During the study duration of 28 days, ionized calcium was measured at admission and then every five days.
Regarding demographic data, brain injury type, and the number of intubated patients, there was no statistically significant difference between the two analyzed groups (P > 0.05). Diffuse axonal damage, subdural hemorrhage, cerebral edema, GCS, and mean blood pressure all showed a statistically significant difference (P < 0.001). On the day of admission and day five, the hypocalcemic group’s serum ionized calcium level was considerably lower than the normocalcemic group (P < 0.001). On the day of admission, there was a significant increase in serum sodium levels in the hpocalcemic group compared to the normocalcemic group (P < 0.05). Between survivors in both groups, there was a significant increase in the length of ICU stays for low serum ionized calcium patients (P < 0.001). When compared to normocalcemic groups, there was a statistically significant increase in 28-day mortality (P = 0.001).
Ionized hypocalcemia on admission and on day five is strongly linked to greater mortality rates in TBI patients.