Prevalence of Hypochloremia in Patients With Heart Failure: A Systematic Review and Meta-Analysis
Xiaoxiao Chen1,2, Rulan Yin1,3, Minxia Lu4
1Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China.
Insights
Hypochloremia, a condition of low serum chloride, affects 14% of heart failure patients globally. This systematic review and meta-analysis provides a comprehensive prevalence estimate for this growing concern.
Area of Science:
- Cardiology
- Electrolyte Imbalance
- Public Health
Background:
- Heart failure (HF) is a significant global health concern.
- Serum chloride levels are increasingly recognized as relevant in HF management.
- Previous estimates of hypochloremia prevalence in HF patients lacked consistency.
Purpose of the Study:
- To determine the global prevalence of hypochloremia in patients diagnosed with heart failure.
- To synthesize existing data through a systematic review and meta-analysis.
Main Methods:
- A systematic search of major biomedical databases (PubMed, Cochrane, Embase, Web of Science, CINAHL) was conducted up to May 24, 2022.
- Included were observational studies defining hypochloremia and reporting its prevalence in HF patients.
- Data were analyzed using a random-effects model, with heterogeneity assessed via Cochran's Q and I² statistics.
Main Results:
- The meta-analysis included 16 papers representing 18 studies with 29,807 HF patients.
- The pooled prevalence of hypochloremia in heart failure was 14.0% (95% CI: 11.9%-16.2%).
- Study country and quality were identified as sources of heterogeneity; publication bias was detected.
Conclusions:
- Hypochloremia is prevalent in 14% of heart failure patients worldwide.
- Further research is needed to understand the clinical implications and management of hypochloremia in HF.
- Addressing heterogeneity and publication bias is crucial for accurate prevalence estimation.
Aim:
The intersection of heart failure (HF) and serum chloride is of increasing interest; however, estimates of the global prevalence of hypochloremia in HF were inconsistent. This paper aimed to quantify the current prevalence of hypochloremia in patients with HF.
Design:
Systematic review and meta-analysis.
Methods:
PubMed, Cochrane, Embase, Web of Science, and CINAHL databases were systematically searched from inception to May 24, 2022. Observational studies that clearly defined the cutoff for hypochloremia and provided the prevalence of hypochloremia in patients with HF were included. Stata 17.0 was used for data analysis. Heterogeneity was assessed according to Cochran's Q and I2 values, and results were pooled using a random-effects model. Sensitivity analysis, subgroup analysis, and meta-regression were used to explore the sources of heterogeneity.
Results:
Sixteen papers reporting 18 studies that involved 29,807 patients with HF were included in the meta-analysis. The pooled prevalence of hypochloremia in HF was 14.0% (95% CI: 11.9%-16.2%; I2 = 96.6%, I2 CI: 95.6%-97.4%, p < 0.001). Study country and study quality were identified in subgroup analysis and meta-regression as possible sources of heterogeneity. Funnel plot and egger's test revealed publication bias (p = 0.02).
Patient Or Public Contribution:
No patient or public contribution.
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