Correlation of initial serum chloride levels in criticalyill ill patients with mortality

Abstract

Disturbances in blood chloride levels, particularly hyperchloremia and hypochloremia, are frequently observed in ICU patients. Despite the prevalence of these abnormalities, their impact on mortality and patient recovery remains inadequately understood. The body of existing research indicates potential links between dyschloremia and adverse clinical outcomes, but further detailed investigations are needed. Given the critical role of electrolyte balance in patient prognosis, this study aims to elucidate the relationship between initial blood chloride levels and mortality in ICU patients. By addressing this gap, we hope to provide clearer guidance for clinical management and improve patient outcomes. Method: A total of 200 patients admitted to the ICU of Imam Reza Hospital from May 23, 2022, to September 20, 2022, were included in the study. Blood chloride levels of the patients at the time of ICU admission were recorded, along with information related to age, gender, patient mortality before discharge, length of ICU stay, data on variables such as base deficit and creatinine levels at ICU admission. Additionally, the incidence of oliguria and AKI, the need for vasopressors and inotropes, the need for blood transfusions, or mechanical ventilation during hospitalization were recorded. Finally, the relationship between initial blood chloride levels and patient mortality, as well as other discussed variables, was examined. Results: Our results showed that in patients with ICU mortality, age (P-value = 0.001), creatinine level (P-value = 0.018), vasopressor use (P-value = 0.001), and intubation (P-value = 0.021) were significantly higher, while urine output and length of ICU stay were lower. Additionally, no significant differences were observed in terms of overall mortality (P-value = 0.333), intubation (P-value = 0.603), and length of ICU stay (P-value = 0.17).