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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  ;  Jun Yong Choi  ;  Young Goo Song  ;  Dong-Ryeol Ryu  ;  June Myung Kim 
 Scientific Reports, Vol.7(1) : 15883, 2017 
Journal Title
 Scientific Reports 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
구남수(Ku, Nam Su) ORCID logo https://orcid.org/0000-0002-9717-4327
김용찬(Kim, Yong Chan)
김은진(Kim, Eun Jin)
김준명(Kim, June Myung)
송영구(Song, Young Goo) ORCID logo https://orcid.org/0000-0002-0733-4156
오동현(Oh, Dong Hyun)
정수진(Jeong, Su Jin)
정인영(Jung, In Young)
최준용(Choi, Jun Yong) ORCID logo https://orcid.org/0000-0002-2775-3315
한상훈(Han, Sang Hoon) ORCID logo https://orcid.org/0000-0002-4278-5198
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