Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2016
Hyperchloremia is associated with 30-day mortality in major trauma patients: a retrospective observational study.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Dysregulated serum chloride and clinical outcomes in critically ill adults: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Association Between Hyperchloremia and Neurological Outcomes in Traumatic Brain Injury: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Bimodal distribution of trauma-related acute kidney injury (TrAKI): A clinical review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Review
- Development of a risk calculator for acute kidney injury in trauma patients: an experimental study.Trauma surgery & acute care open · 2026Article
- Electrolyte Imbalance in Acute Traumatic Brain Injury: Insights from the First 24 h.Clinics and practice · 2024Article
- Advancements in Trauma-Induced Acute Kidney Injury: Diagnostic and Therapeutic Innovations.Life (Basel, Switzerland) · 2024Review
- Hyperchloremia and Hypernatremia Decreased Microglial and Neuronal Survival during Oxygen-Glucose Deprivation/Reperfusion.Biomedicines · 2024Article
- Dyschloremia and Renal Outcomes in Critically Ill Patients With Sepsis: A Prospective Cohort Study: Dyschloremia and Renal Outcomes in Sepsis.Critical care research and practice · 2024Article
- Effect of hyperchloremia on mortality of pediatric trauma patients: a retrospective cohort study.Sao Paulo medical journal = Revista paulista de medicina · 2024Article
- Effect of Pre-Hospital Intravenous Fluids on Initial Metabolic Acid-Base Status in Trauma Patients: A Retrospective Cohort Study.Metabolites · 2023Article
- Intravenous fluid therapy in accordance with kidney injury risk: when to prescribe what volume of which solution.Clinical kidney journal · 2023Review
- Increase in chloride from baseline is independently associated with mortality in intracerebral hemorrhage patients admitted to intensive care unit: A retrospective study.Journal of intensive medicine · 2022Article
- Pediatric Mortality and Acute Kidney Injury Are Associated with Chloride Abnormalities in Intensive Care Units in the United States: A Multicenter Observational Study.Journal of pediatric intensive care · 2022Article
- Association of hyperchloremia with all-cause mortality in patients admitted to the surgical intensive care unit: a retrospective cohort study.BMC anesthesiology · 2022Article
- Subtyping Hyperchloremia among Hospitalized Patients by Machine Learning Consensus Clustering.Medicina (Kaunas, Lithuania) · 2021Article
- Association between the use of balanced fluids and outcomes in critically ill children: a before and after study.Critical care (London, England) · 2021Article
- The Association Between Variability in Electrolytes and the In-Hospital Mortality in Critically Ill Children in Pediatric Intensive Care Units.Frontiers in pediatrics · 2021Article
- High Chloride Burden and Clinical Outcomes in Critically Ill Patients With Large Hemispheric Infarction.Frontiers in neurology · 2021Article
- Aiming for zero fluid accumulation: First, do no harm.Anaesthesiology intensive therapy · 2021Review
- Association of Chloride Ion and Sodium-Chloride Difference With Acute Kidney Injury and Mortality in Critically Ill Patients.Critical care explorations · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChloride is important for maintaining acid-base balance, muscular activity, osmosis and immunomodulation. In patients with major trauma, chloride levels increase after fluid therapy; this is associated with poor clinical outcomes. The purpose of this study was to determine whether hyperchloremia was associated with increased mortality in patients who had sustained major trauma.
methodsThis study enrolled 266 major trauma patients by retrospective chart review, from January 2011 to December 2015. Patients were older than 16 years; were admitted to an intensive care unit; survived more than 48 h; and had sustained major trauma, defined as an injury severity score ≥ 16. Hyperchloremia was defined as a chloride level > 110mEq/L. Delta chloride (Δchloride) was defined as the difference between the serum chloride level measured 48-h post-admission and the initial level. Clinical and laboratory variables were compared between survivors (n = 235) and non-survivors (n = 31). A multivariate logistic regression analysis was performed to assess the association between hyperchloremia 48-h post-admission (hyperchloremia-48) and 30-day mortality.
resultsThe overall 30-day mortality was 11.7 % (n = 31). Hyperchloremia-48 occurred in 65 patients (24.4 %) and the incidence was significantly different between survivors and non-survivors (19.6 vs. 61.3 %, respectively, p < 0.001). Multivariate logistic analysis identified hyperchloremia-48 and Δchloride as independent predictive factors for 30-day mortality in major trauma patients. DISCUSSION: Infusion of chloride-rich solutions, such as normal saline, is itself associated with hyperchloremia, which has been associated with poor patient outcomes. Patients receiving normal saline were more likely to suffer major postoperative complications, acute kidney injury, and infections. Moreover, large changes in serum chloride levels correlated with greater in-hospital mortality.
conclusionHyperchloremia 48-h post-admission and Δchloride was associated with 30-day mortality in major trauma patients. These indices may be useful prognostic markers.
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