• Xiangyuan Ruan, Yifan Gao, Xiaojuan Lai, Baoxin Wang, Jinmei Wu, and Xueshu Yu.
• Department of Intensive Care Unit, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
• J Formos Med Assoc. 2024 May 18.

BackgroundSeptic shock is a lethal disease, and identifying high-risk patients through noninvasive and widely available biomarkers can help improve global outcomes. While the clinical impact of chloride levels on critically ill patients remains unclear, this study aims to investigate the association between hypochloremia and mortality following ICU admission among septic shock patients.MethodsThis is an analysis of data stored in the databases of Medical Information Mart for Intensive Care IV (MIMIC-IV). The initial chloride levels were classified ashypochloremia, normal chloraemia, and hyperchloraemia. A multivariate logistic regression model was applied, adjusting for age, lactate, pH, PO2, urine volume, RDW, creatinine, and liver disease, to assess the association between the three categories of chloride levels and mortality.ResultsOf 3726 patients included in the study, 470 patients (12.6%) had hypochloremia on ICU admission. During the follow-up period, 1120 (33.5%) patients died. Hypochloremia was significantly associated with increased mortality and the incidence of AKI after adjusting for several variables.ConclusionsHypochloremia is independently associated with higher hospital mortality, AKI incidence among septic shock patients. However, further high-quality research is necessary to establish the precise relationship between hypochloremia and septic shock prognosis.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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