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Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients

This study aimed to assess the one-year mortality risk based on discharge serum chloride among the hospital survivors. We analyzed a cohort of adult hospital survivors at a tertiary referral hospital from 2011 through 2013. We categorized discharge serum chloride; ≤96, 97–99, 100–102, 103–105, 106–1...

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Autores principales: Petnak, Tananchai, Thongprayoon, Charat, Cheungpasitporn, Wisit, Bathini, Tarun, Vallabhajosyula, Saraschandra, Chewcharat, Api, Kashani, Kianoush
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353470/
https://www.ncbi.nlm.nih.gov/pubmed/32438557
http://dx.doi.org/10.3390/medsci8020022
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author Petnak, Tananchai
Thongprayoon, Charat
Cheungpasitporn, Wisit
Bathini, Tarun
Vallabhajosyula, Saraschandra
Chewcharat, Api
Kashani, Kianoush
author_facet Petnak, Tananchai
Thongprayoon, Charat
Cheungpasitporn, Wisit
Bathini, Tarun
Vallabhajosyula, Saraschandra
Chewcharat, Api
Kashani, Kianoush
author_sort Petnak, Tananchai
collection PubMed
description This study aimed to assess the one-year mortality risk based on discharge serum chloride among the hospital survivors. We analyzed a cohort of adult hospital survivors at a tertiary referral hospital from 2011 through 2013. We categorized discharge serum chloride; ≤96, 97–99, 100–102, 103–105, 106–108, and ≥109 mmoL/L. We performed Cox proportional hazard analysis to assess the association of discharge serum chloride with one-year mortality after hospital discharge, using discharge serum chloride of 103–105 mmoL/L as the reference group. Of 56,907 eligible patients, 9%, 14%, 26%, 28%, 16%, and 7% of patients had discharge serum chloride of ≤96, 97–99, 100–102, 103–105, 106–108, and ≥109 mmoL/L, respectively. We observed a U-shaped association of discharge serum chloride with one-year mortality, with nadir mortality associated with discharge serum chloride of 103–105 mmoL/L. When adjusting for potential confounders, including discharge serum sodium, discharge serum bicarbonate, and admission serum chloride, one-year mortality was significantly higher in both discharge serum chloride ≤99 hazard ratio (HR): 1.45 and 1.94 for discharge serum chloride of 97–99 and ≤96 mmoL/L, respectively; p < 0.001) and ≥109 mmoL/L (HR: 1.41; p < 0.001), compared with discharge serum chloride of 103–105 mmoL/L. The mortality risk did not differ when discharge serum chloride ranged from 100 to 108 mmoL/L. Of note, there was a significant interaction between admission and discharge serum chloride on one-year mortality. Serum chloride at hospital discharge in the optimal range of 100–108 mmoL/L predicted the favorable survival outcome. Both hypochloremia and hyperchloremia at discharge were associated with increased risk of one-year mortality, independent of admission serum chloride, discharge serum sodium, and serum bicarbonate.
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spelling pubmed-73534702020-07-15 Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients Petnak, Tananchai Thongprayoon, Charat Cheungpasitporn, Wisit Bathini, Tarun Vallabhajosyula, Saraschandra Chewcharat, Api Kashani, Kianoush Med Sci (Basel) Article This study aimed to assess the one-year mortality risk based on discharge serum chloride among the hospital survivors. We analyzed a cohort of adult hospital survivors at a tertiary referral hospital from 2011 through 2013. We categorized discharge serum chloride; ≤96, 97–99, 100–102, 103–105, 106–108, and ≥109 mmoL/L. We performed Cox proportional hazard analysis to assess the association of discharge serum chloride with one-year mortality after hospital discharge, using discharge serum chloride of 103–105 mmoL/L as the reference group. Of 56,907 eligible patients, 9%, 14%, 26%, 28%, 16%, and 7% of patients had discharge serum chloride of ≤96, 97–99, 100–102, 103–105, 106–108, and ≥109 mmoL/L, respectively. We observed a U-shaped association of discharge serum chloride with one-year mortality, with nadir mortality associated with discharge serum chloride of 103–105 mmoL/L. When adjusting for potential confounders, including discharge serum sodium, discharge serum bicarbonate, and admission serum chloride, one-year mortality was significantly higher in both discharge serum chloride ≤99 hazard ratio (HR): 1.45 and 1.94 for discharge serum chloride of 97–99 and ≤96 mmoL/L, respectively; p < 0.001) and ≥109 mmoL/L (HR: 1.41; p < 0.001), compared with discharge serum chloride of 103–105 mmoL/L. The mortality risk did not differ when discharge serum chloride ranged from 100 to 108 mmoL/L. Of note, there was a significant interaction between admission and discharge serum chloride on one-year mortality. Serum chloride at hospital discharge in the optimal range of 100–108 mmoL/L predicted the favorable survival outcome. Both hypochloremia and hyperchloremia at discharge were associated with increased risk of one-year mortality, independent of admission serum chloride, discharge serum sodium, and serum bicarbonate. MDPI 2020-05-19 /pmc/articles/PMC7353470/ /pubmed/32438557 http://dx.doi.org/10.3390/medsci8020022 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Petnak, Tananchai
Thongprayoon, Charat
Cheungpasitporn, Wisit
Bathini, Tarun
Vallabhajosyula, Saraschandra
Chewcharat, Api
Kashani, Kianoush
Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_full Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_fullStr Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_full_unstemmed Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_short Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients
title_sort serum chloride levels at hospital discharge and one-year mortality among hospitalized patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353470/
https://www.ncbi.nlm.nih.gov/pubmed/32438557
http://dx.doi.org/10.3390/medsci8020022
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