Admission serum chloride levels prognostic markers for Heart failure, finds study.

Recent studies have shown that lower serum chloride level is associated with diuretic resistance and increased mortality in heart failure. Impact of lower admission chloride on duration of stay in acute decompensated heart failure (ADHF) has not been studied previously.

Researchers have found in a new  study  that low admission serum chloride levels are important poor prognostic markers of heart failure. The study was published in the journal "Journal of the physicians association of India" 2020.

Heart failure is a multifactorial disease that can be associated with multiple serum electrolyte abnormalities like hyponatremia, hypokalaemia, hypochloraemia, and acid-base disturbances. This can be caused by the maladaptive activation of neurohormonal mechanisms which results in higher solute loss than the free water loss. As recent literature shows that lower serum chloride is associated with diuretic resistance and increased mortality in heart failure but the impact of lower admission chloride on the duration of stay in acute decompensated heart failure has not been studied previously. Hence researchers from various departments of Dayanand Medical College and Hospital studied the effects of admission serum chloride on the duration of hospital stay in patients admitted with acute decompensated heart failure (ADHF).

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The study was a retrospective analysis of 167 patients. Serum chloride levels were divided into three tertiles based on their distribution in the patients. Tertile 1 of <96meq/L, tertile 2 of 96-101 meq/L, and tertile 3 of >101meq/L.

The key findings of the study were:

The median lengths of hospital stay in tertiles 1, 2, and 3 were 8, 7, and 6 days respectively (p = 0.011).

Admission serum chloride levels were inversely associated with duration of stay (p = 0.001).

On multiple linear regression analysis, serum chloride remained an independent predictor of increased hospital stay (p=0.003) while the association with serum sodium was not significant (p=0.07).

1 unit increase in chloride level was associated with 1.3% (p=0.003) decrease in hospital stay (95% CI: 2.2% to 0.5%).

Thus, the researchers concluded that admission serum chloride levels are independently and inversely associated with increased duration of stay and are independent of admission sodium levels. They further added that serum chloride, rather than sodium, is an important poor prognostic marker in heart failure patients.

The present study "Admission Serum Chloride Levels as Predictor of Stay Duration in Acute Decompensated Heart Failure" was published in the journal, "Journal of the physicians association of India."

For further reading, click the following link: Admission Serum Chloride Levels as Predictor of Stay Duration in Acute Decompensated Heart Failure