Association between electrolyte disturbance score and 30-day severe disturbance of consciousness and in-hospital mortality in intensive care unit patients with intracerebral hemorrhage: A retrospective observational cohort study.

ObjectivesIntracerebral hemorrhage is a cerebrovascular disease associated with high mortality and disability rates. Electrolyte disorders are common in intensive care unit patients; however, most current studies have focused on the association between a single electrolyte abnormality and intracerebral hemorrhage prognosis, lacking a comprehensive quantitative assessment of multiple electrolyte disturbances. This study aimed to explore the prognostic value of a multielectrolyte disturbance scoring system for adverse outcomes in intensive care unit patients with intracerebral hemorrhage.MethodsThis retrospective observational cohort study analyzed data from the Medical Information Mart for Intensive Care IV database. A scoring system covering six electrolytes was constructed, with scores assigned according to the abnormal range, number of concurrent abnormalities, and duration. Multivariate logistic and Cox regression analyses were used to evaluate the association between the score and 30-day severe disturbance of consciousness or in-hospital mortality. Subgroup analyses and restricted cubic spline analyses were further performed.ResultsAmong 1540 patients, 321 (20.84%) developed 30-day severe disturbance of consciousness. The electrolyte disturbance score was significantly higher in patients with disturbance of consciousness than in those without disturbance of consciousness. Multivariate regression analysis (Model 3, adjusted for all covariates) showed that, compared with T1, both T2 and T3 were associated with an increased risk of 30-day severe disturbance of consciousness and in-hospital mortality. Subgroup analyses confirmed a stable association across most subgroups. Restricted cubic spline analysis revealed a nonlinear positive correlation between the score and both outcomes, with accelerated risk elevation when the score exceeded 2.ConclusionThe constructed electrolyte disturbance scoring system is a reliable prognostic tool for predicting 30-day severe disturbance of consciousness and in-hospital mortality in intensive care unit patients with intracerebral hemorrhage. A score >2 was associated with a significantly accelerated risk of adverse outcomes, providing a practical threshold for clinical intervention and individualized management.