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

Petnak, Tananchai and Thongprayoon, Charat and Cheungpasitporn, Wisit and Bathini, Tarun and Vallabhajosyula, Saraschandra and Chewcharat, Api and Kashani, Kianoush (2020) Serum Chloride Levels at Hospital Discharge and One-Year Mortality among Hospitalized Patients. Medical Sciences, 8 (2). p. 22. ISSN 2076-3271

[thumbnail of medsci-08-00022.pdf] Text
medsci-08-00022.pdf - Published Version

Download (1MB)

Abstract

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.

Item Type: Article
Subjects: Scholar Eprints > Medical Science
Depositing User: Managing Editor
Date Deposited: 27 Jan 2023 05:29
Last Modified: 20 Sep 2024 04:40
URI: http://repository.stmscientificarchives.com/id/eprint/589

Actions (login required)

View Item
View Item