Is hyperchloremia associated with mortality in critically ill patients? A prospective cohort study.
OBJECTIVE
The aim of the study was to determine if acid-base variables are associated with hospital mortality.


METHODS
This prospective cohort study took place in a university-affiliated hospital intensive care unit (ICU). One hundred seventy-five patients admitted to the ICU during the period of February to May 2007 were included in the study. We recorded clinical data and acid-base variables from all patients at ICU admission. A logistic regression model was constructed using Sepsis-related Organ Failure Assessment (SOFA) score, age, and the acid-base variables.


RESULTS
Individually, none of the variables appear to be good predictors of hospital mortality. However, using the multivariate stepwise logistic regression, we had a model with good discrimination containing SOFA score, age, chloride, and albumin (area under receiver operating characteristic curve, 0.80; 95% confidence interval, 0.73-0.87).


CONCLUSIONS
Hypoalbuminemia and hyperchloremia were associated with mortality. This result involving chloride is something new and should be tested in future studies.
Boniatti
Márcio M
MM
Critical Care Department, Hospital de Clínicas de Porto Alegre, Brazil. marciobt@terra.com.br
Cardoso
Paulo R C
PR
Castilho
Rodrigo K
RK
Vieira
Silvia R R
SR
D000136:Acid-Base Equilibrium; D000328:Adult; D000367:Age Factors; D000368:Aged; D002713:Chlorine / Q000097:blood*; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011445:Prospective Payment System; D018805:Sepsis / Q000097:blood* / Q000401:mortality*; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin; D002713:Chlorine