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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7353470 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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