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Effect of hyperchloremia on mortality of pediatric trauma patients: a retrospective cohort study
Kübra Çeleğen1, Mehmet Çeleğen2
1MD. Physician, Pediatric Nephrologist in Division of Pediatric Nephrology, Department of Pediatrics, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.
Insights
Hyperchloremia, or high serum chloride levels, is linked to increased mortality in pediatric trauma patients. Monitoring chloride levels 48 hours after admission may help predict outcomes.
Area of Science:
- Pediatric Critical Care Medicine
- Trauma Surgery
- Clinical Chemistry
Background:
- Hyperchloremia is common in critically ill children receiving intravenous fluids.
- Elevated serum chloride levels correlate with adverse clinical outcomes in pediatric intensive care units.
Purpose of the Study:
- To investigate the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma.
Main Methods:
- Retrospective cohort study in a Turkish tertiary university hospital (March 2020-April 2022).
- Included pediatric patients (1 month-18 years) with major trauma receiving >0.9% sodium chloride IV fluids.
- Hyperchloremia defined as serum chloride >110 mmol/L; clinical and lab data compared between survivors and nonsurvivors.
Main Results:
- Overall mortality rate was 23% (20 patients).
- Nonsurvivors had a significantly higher incidence of hyperchloremia (P=0.05).
- Hyperchloremia at 48 hours was an independent risk factor for mortality in pediatric major trauma patients.
Conclusions:
- Hyperchloremia at 48 hours post-trauma admission is associated with 28-day mortality in pediatric patients.
- Serum chloride levels may serve as a valuable prognostic indicator in this population.
Background:
Hyperchloremia is often encountered due to the frequent administration of intravenous fluids in critically ill patients with conditions such as shock or hypotension in the pediatric intensive care unit, and high serum levels of chloride are associated with poor clinical outcomes.
Objectives:
This study aimed to determine the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma.
Design And Setting:
This retrospective cohort study was conducted at a tertiary university hospital in Turkey.
Methods:
Data were collected between March 2020 and April 2022. Patients aged 1 month to 18 years with major trauma who received intravenous fluids with a concentration > 0.9% sodium chloride were enrolled. Hyperchloremia was defined as a serum chloride level > 110 mmol/L. Clinical and laboratory data were compared between the survivors and nonsurvivors.
Results:
The mortality rate was 23% (n = 20). The incidence of hyperchloremia was significantly higher in nonsurvivors than in survivors (P = 0.05). In multivariate logistic analysis, hyperchloremia at 48 h was found to be an independent risk factor for mortality in pediatric patients with major trauma.
Conclusions:
In pediatric patients with major trauma, hyperchloremia at 48-h postadmission was associated with 28-day mortality. This parameter might be a beneficial prognostic indicator.
