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- Title
Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients.
- Authors
Breen, Thomas J.; Brueske, Benjamin; Sidhu, Mandeep S.; Kashani, Kianoush B.; Anavekar, Nandan S.; Barsness, Gregory W.; Jentzer, Jacob C.
- Abstract
Purpose: We sought to describe the association between serum chloride levels and mortality among unselected cardiac intensive care unit (CICU) patients. Materials and methods: We retrospectively reviewed adult patients admitted to our CICU from 2007 to 2015. The association of dyschloremia and hospital mortality was assessed in a multiple variable model including additional confounders, and the association of dyschloremia and post-discharge mortality were assessed using Cox proportional-hazards analysis. Results: 9,426 patients with a mean age of 67±15 years (37% females) were included. Admission hypochloremia was present in 1,384 (15%) patients, and hyperchloremia was present in 1,606 (17%) patients. There was a U-shaped relationship between admission chloride and unadjusted hospital mortality, with increased hospital mortality among patients with hypochloremia (unadjusted OR 3.0, 95% CI 2.5–3.6, p<0.001) or hyperchloremia (unadjusted OR 1.9, 95% CI 1.6–2.3, p<0.001). After multivariate adjustment, hypochloremia remained associated with higher hospital mortality (adjusted OR 2.1, 95% CI 1.6–2.9, p <0.001). Post-discharge mortality among hospital survivors was higher among patients with admission hypochloremia (adjusted HR 1.3, 95% CI 1.1–1.6; p<0.001). Conclusion: Abnormal serum chloride on admission to the CICU is associated with increased short- and long-term mortality, with hypochloremia being a strong independent predictor.
- Subjects
CORONARY care units; INTENSIVE care patients; CARDIAC intensive care; HOSPITAL mortality; INTENSIVE care units
- Publication
PLoS ONE, 2021, Vol 16, Issue 4, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0250292