Evidence map›Paper›PMID 36506832›Full record

ArticleCritical care explorations2022

Early Hyperchloremia and Outcomes After Severe Traumatic Brain Injury: Analysis of Resuscitation Outcomes Consortium Hypertonic Saline Trial.

Adnan I Qureshi, Xiaoyu Ma, Wei Huang, Ravi S Nunna, Francisco Gomez, Kunal Malhotra, Niraj Arora, Premkumar N Chandrasekaran, Farhan Siddiq, Camilo R Gomez and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care explorations, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Adnan I QureshiZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Xiaoyu MaZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Wei HuangZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Ravi S NunnaDepartment of Neurosurgery, University of Missouri, Columbia, MO.
Francisco GomezZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Kunal MalhotraDepartment of Nephrology, University of Missouri, Columbia, MO.
Niraj AroraZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Premkumar N ChandrasekaranZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Farhan SiddiqDepartment of Neurosurgery, University of Missouri, Columbia, MO.
Camilo R GomezZeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Jose I SuarezDivision of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Rehabilitation Institute of Kansas City · USUniversity of Missouri · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To investigate the effect of the occurrence of early hyperchloremia on death or severe disability at 180 days in patients with severe traumatic brain injury (TBI).

designPost hoc analysis of Resuscitation Outcomes Consortium Hypertonic Saline (ROC HS)-TBI trial.

settingA total of 114 North American emergency medical services agencies in the ROC. PATIENTS: A total of 991 patients with severe TBI and Glasgow Coma Scale score of less than or equal to 8.

interventionsPrehospital resuscitation with single IV dose (250 cc) of 7.5% saline in 6% dextran-70, 7.5% saline (no dextran), or crystalloid. MEASUREMENTS AND MAIN

resultsPatients with increased serum chloride concentrations (110 mmol/L or greater) 24 hours after randomization were identified. Hyperchloremia was graded into one or greater than or equal to 2 occurrences in the first 24 hours. Logistic regression analyses were performed to determine the effects of hyperchloremia on: 1) death or severe disability at 180 days and 2) death within 180 days after adjusting for confounders. Compared with patients without hyperchloremia, patients with greater than or equal to 2 occurrences of hyperchloremia had significantly higher odds of death or severe disability at 180 days (odds ratio [OR], 1.81; 95% CI, 1.19-2.75) and death within 180 days (OR, 1.89; 95% CI, 1.14-3.08) after adjustment for confounders. However, the total volume of fluids administered during the first 24 hours was an independent predictor of death within 180 days; therefore, after adding an interaction term between the total volume of fluids administered during the first 24 hours and greater than or equal to 2 occurrences of hyperchloremia, patients with greater than or equal to 2 occurrences of hyperchloremia had significantly higher odds of death within 180 days (OR, 2.35; 95% CI, 1.21-4.61 d) but not of composite outcome of death or severe disability at 180 days.

conclusionsAfter modifying for the effect of the total volume of fluids administered during the first 24 hours, multiple occurrences of hyperchloremia in the first 24 hours were associated with higher odds of death within 180 days in patients with severe TBI.

Indexed as

deathdisabilityhyperchloremiahypertonic salinetraumatic brain injury

Identifiers

PMID36506832
PMCPMC9726372
OpenAlexW4310718337

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.