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Prognostic Significance of Community- Versus Hospital-Acquired Hypochloremia in Heart Failure

Author : N.G. Liman, B. B. Siswanto
Upload Date : 19-04-2018

Background: Hypochloremia in acute decompensated heart failure (HF) is indicative of a poor prognosis and predicts morbidity and mortality independent of hyponatremia. The present study compares hospital-acquired hypochloremia (HAHypoCl) with community-acquired hyponatremia (CAHypoCl) in HF patients.

Methods and Results: CAHypoCl was defined as a serum chloride value of <98 mEq/L at the time of hospital admission. HAHypoCl was defined as development of a serum chloride level of <98 mEq/L during hospitalization in the setting of a serum chloride value ≥98 mEq/L on admission. Of 142 consecutive hospitalized patients with a diagnosis of HF, CAHypoCl and HAHypoCl were identified in 44 patients (30.9%) and in 29 patients (20.4%), respectively. Both types of hypochloremia were associated with length of stay and rehospitalization. There were no significant differences between patients with CAHypoCl versus HAHypoCl regarding six month rehospitalization (p= 0.74) and all-cause mortality (p= 0.38).

Conclusion: The present results identified HAHypoCl as a risk factor for increased mortality and rehospitalization in HF as has been previously described for CAHypoCl. Thus, hypochloremia in hospitalized patients with a diagnosis of HF, either on admission or during hospitalization, is a prognostic marker for poor outcomes.

KEYWORDS : heart failure, hypochloremia, mortality, rehospitalization


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