An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock

Hyung Jung Oh, Seung Jun Kim, Yong Chan Kim, Eun Jin Kim, In Young Jung, Dong Hyun Oh, Su Jin Jeong, Nam Su Ku, Sang Hoon Han, JunYong Choi, Young Goo Song, Dong Ryeol Ryu, June Myung Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Only a few observational studies investigated the association between hypochloremia and mortality in critically ill patients, and these studies included small number of septic patients. Also, no study has evaluated the effect of an increase in chloride (Cl-) concentration in hypochloremia on the mortality. A total of 843 Korean septic patients were divided into three groups based on their baseline Cl- level, and Cox analyses were performed to evaluate the 28-day mortality. Moreover, the change in Cl- level (ΔCl) from baseline to 24, 48, or 72 hour was determined, and Cox analyses were also conducted to evaluate the relationship of ΔCl with mortality. 301 (35.7%) patients were hypochloremic (Cl- < 97 mEq/L), and 38 (4.5%) patients were hyperchloremic (Cl- > 110 mEq/L). During the follow-up period, 119 (14.1%) patients died. Hypochloremia was significantly associated with an increased mortality after adjusting for several variables, but an 1 mEq/L increase of ΔCl within 24 hour in patients with hypochloremia was significantly related to a decreased mortality. Caution might be required in severe septic patients with hypochloremia considering their increased mortality rate. However, an increased Cl- concentration might decrease the mortality rate of such patients.

Original languageEnglish
Article number15883
JournalScientific reports
Volume7
Issue number1
DOIs
Publication statusPublished - 2017 Dec 1

Fingerprint

Septic Shock
Chlorides
Sepsis
Mortality
Critical Illness
Observational Studies

All Science Journal Classification (ASJC) codes

  • General

Cite this

Oh, Hyung Jung ; Kim, Seung Jun ; Kim, Yong Chan ; Kim, Eun Jin ; Jung, In Young ; Oh, Dong Hyun ; Jeong, Su Jin ; Ku, Nam Su ; Han, Sang Hoon ; Choi, JunYong ; Song, Young Goo ; Ryu, Dong Ryeol ; Kim, June Myung. / An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock. In: Scientific reports. 2017 ; Vol. 7, No. 1.
@article{0d10299a9d584e339e818e2ac9c30674,
title = "An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock",
abstract = "Only a few observational studies investigated the association between hypochloremia and mortality in critically ill patients, and these studies included small number of septic patients. Also, no study has evaluated the effect of an increase in chloride (Cl-) concentration in hypochloremia on the mortality. A total of 843 Korean septic patients were divided into three groups based on their baseline Cl- level, and Cox analyses were performed to evaluate the 28-day mortality. Moreover, the change in Cl- level (ΔCl) from baseline to 24, 48, or 72 hour was determined, and Cox analyses were also conducted to evaluate the relationship of ΔCl with mortality. 301 (35.7{\%}) patients were hypochloremic (Cl- < 97 mEq/L), and 38 (4.5{\%}) patients were hyperchloremic (Cl- > 110 mEq/L). During the follow-up period, 119 (14.1{\%}) patients died. Hypochloremia was significantly associated with an increased mortality after adjusting for several variables, but an 1 mEq/L increase of ΔCl within 24 hour in patients with hypochloremia was significantly related to a decreased mortality. Caution might be required in severe septic patients with hypochloremia considering their increased mortality rate. However, an increased Cl- concentration might decrease the mortality rate of such patients.",
author = "Oh, {Hyung Jung} and Kim, {Seung Jun} and Kim, {Yong Chan} and Kim, {Eun Jin} and Jung, {In Young} and Oh, {Dong Hyun} and Jeong, {Su Jin} and Ku, {Nam Su} and Han, {Sang Hoon} and JunYong Choi and Song, {Young Goo} and Ryu, {Dong Ryeol} and Kim, {June Myung}",
year = "2017",
month = "12",
day = "1",
doi = "10.1038/s41598-017-16238-z",
language = "English",
volume = "7",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

Oh, HJ, Kim, SJ, Kim, YC, Kim, EJ, Jung, IY, Oh, DH, Jeong, SJ, Ku, NS, Han, SH, Choi, J, Song, YG, Ryu, DR & Kim, JM 2017, 'An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock', Scientific reports, vol. 7, no. 1, 15883. https://doi.org/10.1038/s41598-017-16238-z

An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock. / Oh, Hyung Jung; Kim, Seung Jun; Kim, Yong Chan; Kim, Eun Jin; Jung, In Young; Oh, Dong Hyun; Jeong, Su Jin; Ku, Nam Su; Han, Sang Hoon; Choi, JunYong; Song, Young Goo; Ryu, Dong Ryeol; Kim, June Myung.

In: Scientific reports, Vol. 7, No. 1, 15883, 01.12.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock

AU - Oh, Hyung Jung

AU - Kim, Seung Jun

AU - Kim, Yong Chan

AU - Kim, Eun Jin

AU - Jung, In Young

AU - Oh, Dong Hyun

AU - Jeong, Su Jin

AU - Ku, Nam Su

AU - Han, Sang Hoon

AU - Choi, JunYong

AU - Song, Young Goo

AU - Ryu, Dong Ryeol

AU - Kim, June Myung

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Only a few observational studies investigated the association between hypochloremia and mortality in critically ill patients, and these studies included small number of septic patients. Also, no study has evaluated the effect of an increase in chloride (Cl-) concentration in hypochloremia on the mortality. A total of 843 Korean septic patients were divided into three groups based on their baseline Cl- level, and Cox analyses were performed to evaluate the 28-day mortality. Moreover, the change in Cl- level (ΔCl) from baseline to 24, 48, or 72 hour was determined, and Cox analyses were also conducted to evaluate the relationship of ΔCl with mortality. 301 (35.7%) patients were hypochloremic (Cl- < 97 mEq/L), and 38 (4.5%) patients were hyperchloremic (Cl- > 110 mEq/L). During the follow-up period, 119 (14.1%) patients died. Hypochloremia was significantly associated with an increased mortality after adjusting for several variables, but an 1 mEq/L increase of ΔCl within 24 hour in patients with hypochloremia was significantly related to a decreased mortality. Caution might be required in severe septic patients with hypochloremia considering their increased mortality rate. However, an increased Cl- concentration might decrease the mortality rate of such patients.

AB - Only a few observational studies investigated the association between hypochloremia and mortality in critically ill patients, and these studies included small number of septic patients. Also, no study has evaluated the effect of an increase in chloride (Cl-) concentration in hypochloremia on the mortality. A total of 843 Korean septic patients were divided into three groups based on their baseline Cl- level, and Cox analyses were performed to evaluate the 28-day mortality. Moreover, the change in Cl- level (ΔCl) from baseline to 24, 48, or 72 hour was determined, and Cox analyses were also conducted to evaluate the relationship of ΔCl with mortality. 301 (35.7%) patients were hypochloremic (Cl- < 97 mEq/L), and 38 (4.5%) patients were hyperchloremic (Cl- > 110 mEq/L). During the follow-up period, 119 (14.1%) patients died. Hypochloremia was significantly associated with an increased mortality after adjusting for several variables, but an 1 mEq/L increase of ΔCl within 24 hour in patients with hypochloremia was significantly related to a decreased mortality. Caution might be required in severe septic patients with hypochloremia considering their increased mortality rate. However, an increased Cl- concentration might decrease the mortality rate of such patients.

UR - http://www.scopus.com/inward/record.url?scp=85034749751&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034749751&partnerID=8YFLogxK

U2 - 10.1038/s41598-017-16238-z

DO - 10.1038/s41598-017-16238-z

M3 - Article

VL - 7

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

M1 - 15883

ER -