Frequency of hyperchloremia and mortality in patients presenting with sepsis at tertiary care hospital, Karachi
DOI:
https://doi.org/10.61529/idjp.v35i3.586Abstract
Background: Hyperchloremia is frequently encountered in critically ill patients with sepsis and may reflect disease severity, altered renal handling, or exposure to chloride-rich intravenous fluids. This study was designed to assess the prevalence and in-hospital mortality for hyperchloremia in patients with sepsis.
Material and Methods: This cross-sectional study included 165 adults aged 30 to 80 years admitted with sepsis to the Department of Medicine, Aga Khan University Hospital, Karachi. Chloride was tested within 12 hours of admission and hyperchloremia was defined as >107 milliequivalents per liter (mEq/L). Demographic characteristics, comorbidities, intensive care unit admission and in-hospital mortality were documented. Chi-square test or Fisher's exact test was used to assess associations with a p-value ≤0.05 regarded as statistically significant.
Results: Hyperchloremia was present in 66 (40.0%) of 165 patients and 33 (20.0%) patients died during hospital stay. Patients with sepsis duration >24 hours had significantly higher incidence of hyperchloremia compared to those with ≤24 hours duration of sepsis (73.1% vs. 33.8%, p<0.001). Important associations were also noted with diabetes mellitus (p=0.001), hypertension (p=0.002), dyslipidemia (p=0.006) and anaemia (p<0.001). Among the patients who had hyperchloremia, 16 (24.2%) died compared with 17 (17.2%) patients who did not have hyperchloremia; this was not statistically significant (p=0.266).
Conclusions: Hyperchloremia was prevalent in patients with sepsis and was linked to longer sepsis duration and specific co-morbidities. While there was a higher number of deaths in the hyperchloremic group, hyperchloremia was not significantly related to in-hospital death.
Keywords: Chlorides, Critical care, Fluid therapy, Hospital mortality, Sepsis.
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