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Hypochloraemia is associated with 28-day mortality in patients with septic shock: a retrospective analysis of a multicentre prospective registry

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Abstract
Objectives Hyperchloraemia is associated with poor
clinical outcomes in sepsis patients; however, this
association is not well studied for hypochloraemia. We
investigated the prevalence of chloride imbalance and
the association between hypochloraemia and 28-day
mortality in ED patients with septic shock.
Methods A retrospective analysis of data from 11
multicentre EDs in the Republic of Korea prospectively
collected from October 2015 to April 2018 was
performed. Initial chloride levels were categorised as
hypochloraemia, normochloraemia and hyperchloraemia,
according to sodium chloride difference adjusted
criteria. The primary outcome was 28-day
mortality. A
multivariate logistic regression model adjusting for age,
sex, comorbidities, acid-base
state, sepsis-related
organ
failure assessment (SOFA) score, lactate and albumin
level was used to test the association between the three
chloride categories and 28-day
mortality.
Results Among 2037 enrolled patients, 394
(19.3%), 1582 (77.7%) and 61 (3.0%) patients had
hypochloraemia, normochloraemia and hyperchloraemia,
respectively. The unadjusted 28-day
mortality rate in
patients with hypochloraemia was 27.4% (95% CI,
23.1% to 32.1%), which was higher than in patients
with normochloraemia (19.7%; 95% CI, 17.8% to
21.8%). Hypochloraemia was associated with an
increase in the risk of 28-day
mortality (adjusted OR
(aOR), 1.36, 95% CI, 1.00 to 1.83) after adjusting
for confounders. However, hyperchloraemia was not
associated with 28-day
mortality (aOR 1.35, 95% CI,
0.82 to 2.24).
Conclusion Hypochloraemia was more frequently
observed than hyperchloraemia in ED patients with septic
shock and it was associated with 28-day
mortality.
Author(s)
강구현김경수김원영서길준신종환신태건이민성임태호조유환최성혁한갑수황윤정
Issued Date
2021
Type
Article
Keyword
AcidosisAcidsAlkalosisBlood pressureCardiovascular diseaseChlorideChronic illnessesClinical outcomesEmergency medical careHospitalsHypotensionIntensive careKidney diseasesLiver diseasesLung diseasesMortalityPatientsSepsisSodiumVariables
DOI
10.1136/emermed-2019-209239
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8021
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2440475041&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Hypochloraemia%20is%20associated%20with%2028-day%20mortality%20in%20patients%20with%20septic%20shock:%20a%20retrospective%20analysis%20of%20a%20multicentre%20prospective%20registry&offset=0&pcAvailability=true
Publisher
EMERGENCY MEDICINE JOURNAL
Location
미국
Language
한국어
ISSN
1472-0205
Citation Volume
38
Citation Number
6
Citation Start Page
423
Citation End Page
429
Appears in Collections:
Medicine > Medicine
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