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Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients

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 hospi...

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Autores principales: Breen, Thomas J., Brueske, Benjamin, Sidhu, Mandeep S., Kashani, Kianoush B., Anavekar, Nandan S., Barsness, Gregory W., Jentzer, Jacob C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075550/
https://www.ncbi.nlm.nih.gov/pubmed/33901227
http://dx.doi.org/10.1371/journal.pone.0250292
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author Breen, Thomas J.
Brueske, Benjamin
Sidhu, Mandeep S.
Kashani, Kianoush B.
Anavekar, Nandan S.
Barsness, Gregory W.
Jentzer, Jacob C.
author_facet Breen, Thomas J.
Brueske, Benjamin
Sidhu, Mandeep S.
Kashani, Kianoush B.
Anavekar, Nandan S.
Barsness, Gregory W.
Jentzer, Jacob C.
author_sort Breen, Thomas J.
collection PubMed
description 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.
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spelling pubmed-80755502021-05-05 Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients Breen, Thomas J. Brueske, Benjamin Sidhu, Mandeep S. Kashani, Kianoush B. Anavekar, Nandan S. Barsness, Gregory W. Jentzer, Jacob C. PLoS One Research Article 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. Public Library of Science 2021-04-26 /pmc/articles/PMC8075550/ /pubmed/33901227 http://dx.doi.org/10.1371/journal.pone.0250292 Text en © 2021 Breen et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Breen, Thomas J.
Brueske, Benjamin
Sidhu, Mandeep S.
Kashani, Kianoush B.
Anavekar, Nandan S.
Barsness, Gregory W.
Jentzer, Jacob C.
Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
title Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
title_full Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
title_fullStr Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
title_full_unstemmed Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
title_short Abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
title_sort abnormal serum chloride is associated with increased mortality among unselected cardiac intensive care unit patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075550/
https://www.ncbi.nlm.nih.gov/pubmed/33901227
http://dx.doi.org/10.1371/journal.pone.0250292
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