Abstract

AGUILAR ARZAPALO, Mario Francisco et al. Association of elevated levels of plasma chloride, in severity and mortality, in adult patients in the Intensive Care Unit. Rev. Asoc. Mex. Med. Crít. Ter. Intensiva [online]. 2015, vol.29, n.1, pp.13-21. ISSN 0187-8433.

Background: Since long time ago, many investigators have tried to demonstrate increased mortality associated with acid base disturbances. In this study, we sought to determine the association of hyperchloremia (serum chloride > 110 mEq/L measured at ICU admission) and whether this electrolyte disturbance is associated with an increase morbidity and mortality. Methods: Data were retrospectively collected on consecutive adult patients admitted to "Dr. Agustin O'Horán" Hospital Intensive Care Unit, between January 2011 to July 2014 (> 18 years of age) who underwent inpatient medical treatment using electronic files. The impact of admission hyperchloremia on patient morbidity and mortality was examined using risk or the rate ratio of disease in the exposed cohort compared with the rate of risk in the unexposed cohort, and χ² measurable data on a nominal scale. Results: The dataset consisted of 936 medical files and serum chloride concentration value on admission, being 853 eligible. Hyperchloremia (serum chloride > 110 mmol/L) is quite common, with an incidence of 47.71%. Patients were propensity-matched based on their association with death and hyperchloremia. Of the 853 patients collected, patients with hyperchloremia after admission (n = 446, 52.3%) patients were matched to patients who had normal serum chloride levels after admission. These 2 groups were well balanced with respect to all variables collected. The hyperchloremic group was at increased risk of mortality at ICU discharge, relative risk ratio = 1.81; 95% confidence interval, 1.41 versus 2.51 risk increase of 25.31%. Patients with admission hyperchloremia were more likely to have death association and increase in severity scales statistically important. Conclusion: This retrospective cohort trial demonstrates an association between hyperchloremia and poor ICU admission outcome (death). Additional studies are required to demonstrate a causal relationship between these variables.

Keywords : Chloride; hyperchloremia; mortality.

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