Table 1.
Baseline characteristics at the time of ED admission among three groups (hypochloremia, normochloremia, and hyperchloremia)*.
| Variables | Total (n = 843, 100%) | Hypochloremia (n = 301, 35.7%) | Normochloremia (n = 504, 59.8%) | Hyperchloremia (n = 38, 4.5%) | p-value |
|---|---|---|---|---|---|
| Age, years | 65.8 ± 14.1 | 64.4 ± 13.8 | 66.4 ± 14.1 | 69.7 ± 15.3 | 0.030 |
| Male, n(%) | 434 (51.5%) | 162 (53.8%) | 255 (50.6%) | 17 (44.7%) | 0.470 |
| BMI, kg/m2 | 23.1 ± 6.3 | 22.9 ± 6.8 | 23.2 ± 6.0 | 23.0 ± 4.1 | 0.797 |
| SBP, mmHg | 84.1 ± 24.3 | 83.6 ± 24.9 | 84.7 ± 24.5 | 80.1 ± 13.8 | 0.485 |
| DBP, mmHg | 53.2 ± 13.3 | 53.5 ± 13.9 | 53.0 ± 13.2 | 53.5 ± 13.3 | 0.885 |
| MAP, mmHg | 63.5 ± 16.0 | 63.5 ± 16.7 | 63.6 ± 16.0 | 62.3 ± 10.5 | 0.902 |
| SOFA score | 8.4 ± 3.0 | 8.9 ± 3.0 | 8.0 ± 2.9 | 9.6 ± 3.1 | <0.001 |
| APACHE II score | 16.9 ± 6.7 | 18.7 ± 5.9 | 15.3 ± 7.1 | 20.4 ± 10.8 | 0.003 |
| Comorbidity disease, n(%) | |||||
| DM | 294 (34.9%) | 114 (37.9%) | 168 (33.3%) | 12 (31.6%) | 0.387 |
| Hypertension | 461 (54.7%) | 159 (52.8%) | 281 (55.8%) | 21 (55.3%) | 0.720 |
| CHF | 70 (8.3%) | 34 (11.3%) | 34 (6.7%) | 2 (5.3%) | 0.061 |
| CVA | 136 (16.1%) | 42 (14.0%) | 85 (16.9%) | 9 (23.7%) | 0.240 |
| CAD | 100 (11.9%) | 34 (11.3%) | 62 (12.3%) | 4 (10.5%) | 0.882 |
| Dementia | 44 (5.2%) | 12 (4.0%) | 27 (5.4%) | 5 (13.2%) | 0.056 |
| Cancer | 286 (33.9%) | 103 (34.2%) | 166 (32.9%) | 17 (44.7%) | 0.331 |
| Chronic lung disease | 118 (14.0%) | 39 (13.0%) | 74 (14.7%) | 5 (13.2%) | 0.783 |
| Chronic liver disease | 89 (10.6%) | 32 (10.6%) | 55 (10.9%) | 2 (5.3%) | 0.550 |
| Chronic kidney disease | 143 (17.0%) | 51 (16.9%) | 86 (17.1%) | 6 (15.8%) | 0.980 |
| Acute kidney injury, n(%) | 425 (50.4%) | 176 (58.5%) | 224 (44.4%) | 25 (65.8%) | 0.011 |
| Vasopressor needs, n(%) | 776 (92.1%) | 276 (91.7%) | 465 (92.3%) | 35 (92.1%) | 0.852 |
| Mechanical ventilation, n(%) | 208 (24.7%) | 72 (23.9%) | 125(24.8%) | 11 (28.9%) | 0.791 |
| Mean daily fluid balance (L/d)† | 0.6 ± 1.3 | 0.5 ± 1.5 | 0.4 ± 1.4 | 0.6 ± 1.7 | 0.304 |
| Mean daily infused 0.9% saline, (L/d)†† | 1.5 ± 0.7 | 1.5 ± 0.7 | 1.5 ± 0.7 | 1.4 ± 0.8 | 0.636 |
| Laboratory values | |||||
| WBC, × 103/mm3 | 13.8 ± 10.6 | 15.1 ± 11.1 | 13.2 ± 10.5 | 11.3 ± 6.4 | 0.013 |
| Hb, g/dL | 12.3 ± 7.2 | 12.5 ± 8.6 | 12.2 ± 6.4 | 11.6 ± 2.5 | 0.705 |
| Platelet, × 103/mm3 | 199.5 ± 147.5 | 222.0 ± 202.6 | 186.6 ± 103.9 | 192.6 ± 95.8 | 0.004 |
| BUN, mg/dL | 34.7 ± 28.3 | 40.9 ± 36.0 | 29.7 ± 20.4 | 51.5 ± 34.5 | <0.001 |
| Creatinine, mg/dL | 2.1 ± 2.0 | 2.7 ± 2.6 | 1.8 ± 1.3 | 2.7 ± 2.0 | 0.005 |
| Albumin, g/dL | 3.1 ± 0.7 | 3.0 ± 0.7 | 3.1 ± 0.7 | 2.9 ± 0.7 | 0.028 |
| Total bilirubin, mg/dL | 1.3 ± 1.6 | 1.4 ± 1.6 | 1.2 ± 1.4 | 1.3 ± 3.1 | 0.310 |
| Lactate, mg/dL | 4.2 ± 3.5 | 5.0 ± 4.1 | 3.7 ± 3.0 | 4.3 ± 2.9 | <0.001 |
| CRP, mg/L | 146.6 ± 107.4 | 174.7 ± 109.9 | 131.0 ± 100.5 | 132.6 ± 131.0 | <0.001 |
| Sodium, mEq/L | 135.1 ± 6.2 | 130.2 ± 5.4 | 137.3 ± 3.9 | 145.6 ± 7.3 | <0.001 |
| Potassium, mEq/L | 4.2 ± 0.9 | 4.4 ± 1.0 | 4.1 ± 0.8 | 4.3 ± 1.0 | <0.001 |
| Chloride, mEq/L | 99.4 ± 7.1 | 92.3 ± 5.0 | 102.5 ± 3.1 | 114.6 ± 3.6 | <0.001 |
| total CO2, mEq/L | 17.7 ± 5.2 | 17.5 ± 6.1 | 18.2 ± 4.5 | 13.5 ± 4.0 | <0.001 |
| 28-day mortality, n(%) | 119 (14.1%) | 59 (19.6%) | 53 (10.5%) | 7 (18.4%) | 0.001 |
Data are expressed as mean (with standard deviation) or n (%). Abbreviations; ED, emergency department; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; SOFA, sequential organ failure assessment; APACHE, acute physiology and chronic health evaluation; DM, diabetes mellitus; CHF, congestive heart failure; CVA, cerebrovascular accidents; CAD, coronary arterial disease; WBC, white blood cell; Hb, hemoglobin; BUN, blood urea nitrogen; CRP, C-reactive protein. *We investigated baseline demographic and laboratory data based on the time of patients’ ED admission, and stratified these data based on the hypochloremia, normochloremia, and hyperchloremia groups. Hypochloremia; chloride level less than 98 mEq/L at baseline. Normochloremia; chloride level between 98 to 110 mEq/L at baseline. Hyperchloremia; chloride level over 110 mEq/L at baseline. †To quantify 72-hour cumulative fluid balance, we used the following formula: [∑daily (fluid intake (L)−total output (L)], which was defined as “net fluid accumulation for 72 hours”. “Mean daily fluid balance” was calculated as the arithmetic mean of the daily fluid balance from the admission of ED to 72 hours. ††According to our policy of the solution for severe sepsis, we usually use 0.9% saline.