WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Ghaith Jabbar Waheed* and Ibrahim Khalil Al Shemari

ABSTRACT

Background: Electrolyte disturbances, including hyperchloremia, are frequently observed in critically ill patients with severe sepsis and septic shock. However, the association between hyperchloremia and hospital mortality remains unclear. Aim: This study aimed to evaluate the relationship between hyperchloremia and hospital mortality in patients with severe sepsis and septic shock. Patients and Method: In this prospective cohort study, 100 patients diagnosed with severe sepsis and septic shock were included. Serum chloride levels were measured at admission and after 72 hours. Based on the chloride level at 72 hours, patients were divided into two groups: hyperchloremic (Cl72 ≥110 mEq/L, N=50) and non-hyperchloremic (Cl72 <110 mEq/L, N=50). Baseline clinical and laboratory data were also recorded. Results: The mean age of the patients was 57.5±20.51 years. After 72 hours of admission, 50% of patients developed hyperchloremia. Compared to the non-hyperchloremic group, patients with Cl72 ≥110 mEq/L showed a significantly higher prevalence of acute kidney injury (72% vs. 20%), need for dialysis (24% vs. 4%), respiratory failure (80% vs. 40%), mechanical ventilation (72% vs. 24%), shock (76% vs. 36%), and use of vasopressors/inotropes (76% vs. 36%). Notably, the hospital mortality rate was markedly higher in the hyperchloremic group (84% vs. 28%). Conclusion: Hyperchloremia at 72 hours is associated with increased mortality and worse clinical outcomes in septic patients. Reducing the use of high-chloride intravenous fluids may improve outcomes in this population.