Association Between Serum Chloride and In-hospital Mortality Risk Among Patients with Heart Failure
Objective To investigate the association between serum chloride levels on admission and the risk of in-hospital mortality in patients with heart failure.Methods A total of 1 098 patients with heart failure in the Department of Cardiology of Zhengzhou People's Hospital from January 2018 to December 2021 were selected.Patients were divided into three groups based on their serum chloride levels on admission:70-103 mmol·L-1group(low quartile group,390 cases),103-105 mmol·L-1 group(middle quartile group,321 cases),and 105-125 mmol·L-1 group(high quartile group,387 cases).The primary endpoint was in-hospital death.Logistic regression analysis was performed to examine the association between serum chloride levels on admission and the risk of in-hospital mortality.Results Patients with heart failure and lower serum chloride levels(＜103 mmol·L-1 group)had higher levels of NT-proBNP,glutamate,creatinine and diuretic use(P＜0.05).Univariate logistic regression analysis showed that the middle and high quartile groups had a reduced risk of in-hospital death from heart failure compared with the low quartile group[OR(95％CI)was 0.40(0.14-0.90),P=0.020;OR(95％CI)was 0.36(0.10-0.82),P＜0.001],respectively.Compared with the low tertile group,the high tertile group was associated with a reduced rehospitalisation risk for heart failure[OR(95％CI)was 0.50(0.29-0.86),P=0.013].In addition,multifactorial logistic regression analysis showed that patients in the high quartile group had a reduced risk of in-hospital death from heart failure[OR(95％CI)was 0.10(0.01-0.98),P=0.049].However,the median group did not reach statistical significance.Statistical significance was no longer significant between serum chloride and rehospitalisation risk for heart failure in the multifactorial analysis.The dose-response curve showed the lowest risk of in-hospital death at serum chloride levels of 105-110 mmol·L-1.Conclusion Elevated serum chloride levels on admission are associated with reduced in-hospital mortality in patients with heart failure.
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