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Hyperchloremia is associated with 30-day mortality in major trauma patients: a retrospective observational study

Overview of attention for article published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, October 2016
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Title
Hyperchloremia is associated with 30-day mortality in major trauma patients: a retrospective observational study
Published in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, October 2016
DOI 10.1186/s13049-016-0311-7
Pubmed ID
Authors

Jin Young Lee, Tae Hwa Hong, Kyung Won Lee, Myung Jae Jung, Jae Gil Lee, Seung Hwan Lee

Abstract

Chloride 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. This 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. The 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. 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. Hyperchloremia 48-h post-admission and Δchloride was associated with 30-day mortality in major trauma patients. These indices may be useful prognostic markers.

Mendeley readers

The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 30 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 27%
Student > Postgraduate 4 13%
Professor 3 10%
Other 3 10%
Researcher 3 10%
Other 7 23%
Unknown 2 7%
Readers by discipline Count As %
Medicine and Dentistry 22 73%
Unspecified 2 7%
Biochemistry, Genetics and Molecular Biology 1 3%
Chemistry 1 3%
Business, Management and Accounting 1 3%
Other 0 0%
Unknown 3 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 October 2017.
All research outputs
#7,528,066
of 12,043,827 outputs
Outputs from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#553
of 748 outputs
Outputs of similar age
#160,409
of 284,743 outputs
Outputs of similar age from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#23
of 28 outputs
Altmetric has tracked 12,043,827 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 748 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 284,743 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 28 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.