Is hyperchloremia associated with mortality in critically ill patients? A prospective cohort study

Area of Science:

• Critical Care Medicine
• Clinical Chemistry
• Biostatistics

Background:

• Hospital mortality is a critical outcome measure in intensive care units (ICUs).
• Understanding predictors of mortality is essential for improving patient care and resource allocation.
• Acid-base balance plays a crucial role in physiological function and can be altered in critically ill patients.

Purpose of the Study:

• To investigate the association between acid-base variables and hospital mortality in ICU patients.
• To identify specific acid-base parameters that predict mortality.
• To develop a predictive model for hospital mortality using clinical and biochemical data.

Main Methods:

• Prospective cohort study conducted in a university-affiliated hospital ICU.
• Inclusion of 175 patients admitted to the ICU.
• Logistic regression analysis incorporating Sepsis-related Organ Failure Assessment (SOFA) score, age, and acid-base variables.

Main Results:

• Individually, acid-base variables were not strong predictors of hospital mortality.
• A multivariate logistic regression model demonstrated good predictive discrimination (AUC=0.80).
• The final model included SOFA score, age, chloride, and albumin levels as significant predictors.

Conclusions:

• Hypoalbuminemia and hyperchloremia are associated with increased hospital mortality.
• Chloride levels, specifically hyperchloremia, emerged as a novel predictor of mortality.
• Further research is warranted to validate the role of chloride in predicting mortality in critically ill patients.