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Related Experiment Video

Updated: Aug 9, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Community-based serum chloride abnormalities predict mortality risk.

Tali Shafat1,2, Victor Novack1, Leonid Barski2

  • 1Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel.

Plos One
|February 22, 2023
PubMed
Summary
This summary is machine-generated.

Ambulatory serum chloride abnormalities, particularly hypochloremia (low chloride), significantly increase mortality risk in outpatients. This risk is dose-dependent, with lower chloride levels correlating to higher mortality.

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Area of Science:

  • Clinical Medicine
  • Nephrology
  • Electrolyte Imbalance

Background:

  • Ambulatory serum chloride levels are often overlooked in clinical practice.
  • Understanding the prognostic implications of chloride abnormalities is crucial for patient outcomes.
  • Previous research has not fully elucidated the mortality risk associated with outpatient chloride levels.

Purpose of the Study:

  • To evaluate the prognostic significance of serum chloride abnormalities in a large outpatient population.
  • To determine the association between hypochloremia and hyperchloremia and all-cause mortality.
  • To investigate the dose-dependent relationship between serum chloride levels and mortality risk.

Main Methods:

  • A population-based study analyzed data from 105,655 non-hospitalized adult patients in Israel.
  • Serum chloride tests (≥3 per patient) were collected between 2005 and 2016.
  • Cox proportional hazards models assessed mortality risk associated with low (≤97 mmol/l) and high (≥107 mmol/l) chloride levels.

Main Results:

  • Hypochloremia (≤97 mmol/l) was independently linked to a 2.41-fold increased all-cause mortality risk.
  • Hyperchloremia (≥108 mmol/l) was associated with a 1.14-fold increased mortality risk.
  • A dose-dependent elevated mortality risk was observed for chloride levels ≤105 mmol/l.

Conclusions:

  • Hypochloremia in the outpatient setting is a significant independent predictor of increased all-cause mortality.
  • The mortality risk associated with hypochloremia is dose-dependent.
  • Even chloride levels within the lower end of the 'normal' range may indicate elevated mortality risk.