机构：[1]Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China[2]Department of Neurology, The Third Affiliated Hospital of Inner Mongolia Medical University, Baotou, China[3]The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia[4]Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China[5]Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou, China[6]Department of Neurology, Changshu First People’s Hospital, Suzhou, China[7]Department of Neurology, Zhangjiagang First People’s Hospital, Suzhou, China[8]Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, China[9]Institutes of Neuroscience, Soochow University, Suzhou, China
ObjectivesThe impact of electrolyte imbalance on clinical outcomes after acute ischemic stroke (AIS) is still not understood. We investigated the association between hypochloremia and hyponatremia upon hospital admission and in-hospital mortality in AIS patients. Materials and methodsA total of 3314 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in this study. Hypochloremia was defined as having a serum chloride concentration <98mmol/L and hyponatremia as having a serum sodium concentration <135mmol/L. The Cox proportional hazard model was used to examine the effect of hypochloremia and hyponatremia on all-cause in-hospital mortality in AIS patients. ResultsDuring hospitalization, 118 patients (3.6%) died from all causes. Multivariable model adjusted for age, sex, baseline National Institutes of Health Stroke Scale score, serum sodium, and other potential covariates showed that hypochloremia was associated with a 2.43-fold increase in the risk of in-hospital mortality (hazard ratio [HR] 2.43; 95% confidence interval [CI], 1.41-4.19; P=.001). However, no significant association between hyponatremia (P=.905) and in-hospital mortality was observed. Moreover, the multivariable analysis found that serum chloride (HR=0.92, 95% CI 0.88-0.98; P=.004) but not serum sodium (P=.102) was significantly associated with in-hospital mortality. ConclusionsHypochloremia at admission was independently associated with in-hospital mortality in AIS patients.
基金：
This work was supported in part by grants
from the National Natural Science Foundation
of China (81471195), Suzhou Clinical
Research Center of Neurological Disease
(Szzx201503) and Jiangsu Provincial Medical
Key Discipline Project, The Second Affiliated
Hospital of Soochow University Preponderant
Clinic Discipline Group Project Funding
(XKQ2015002). This was also partly supported
by the Priority Academic Program Development
of Jiangsu Higher Education Institutions (PAPD).
第一作者机构：[1]Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China[2]Department of Neurology, The Third Affiliated Hospital of Inner Mongolia Medical University, Baotou, China
共同第一作者：
通讯作者：
通讯机构：[*1]Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
推荐引用方式(GB/T 7714)：
H.-Z. Bei,S.-J. You,D. Zheng,et al.Prognostic role of hypochloremia in acute ischemic stroke patients[J].ACTA NEUROLOGICA SCANDINAVICA.2017,136(6):672-679.doi:10.1111/ane.12785.
APA：
H.-Z. Bei,S.-J. You,D. Zheng,C.-K. Zhong,H.-P. Du...&C.-F. Liu.(2017).Prognostic role of hypochloremia in acute ischemic stroke patients.ACTA NEUROLOGICA SCANDINAVICA,136,(6)
MLA：
H.-Z. Bei,et al."Prognostic role of hypochloremia in acute ischemic stroke patients".ACTA NEUROLOGICA SCANDINAVICA 136..6(2017):672-679
