PDF(Pubmed)
Abstract：
UNASSIGNED: Congestive heart failure (CHF) demonstrates a heightened prevalence in individuals with diabetes mellitus within Intensive Care Units. The occurrence of abnormal chloride levels is frequently observed in critically ill patients, yet its clinical significance remains subject to debate. This study endeavors to explore the relationship between serum chloride levels and in-hospital mortality among patients affected by both congestive heart failure and diabetes.
UNASSIGNED: A retrospective cohort study was conducted, utilizing data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, focusing on adult patients in the United States. The impact of serum chloride levels upon ICU admission on in-hospital mortality was analyzed using multivariable logistic regression models, generalized additive models and subgroup analysis.
UNASSIGNED: The study encompassed 7,063 patients with coexisting diabetes and congestive heart failure. The fully adjusted model revealed an inverse association between serum chloride levels and in-hospital mortality. As a tertile variable (Q3 vs Q1), the odds ratio (OR) was 0.73 with a 95% confidence interval (CI) of 0.54-0.98 (p = 0.039). As a continuous variable, per 1 mmol/L increment, the OR (95% CI) was 0.97 (0.96-0.99, p = 0.01). The relationship between serum chloride and in-hospital mortality demonstrated linearity (non-linear p = 0.958). Stratified analyses further validated the robustness of this correlation.
UNASSIGNED: Serum chloride levels exhibited a negative association with in-hospital mortality in patients with both congestive heart failure and diabetes. Nevertheless, prospective, randomized, controlled studies are warranted to corroborate and validate the findings presented in this investigation.
UNASSIGNED: A retrospective cohort study was conducted, utilizing data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, focusing on adult patients in the United States. The impact of serum chloride levels upon ICU admission on in-hospital mortality was analyzed using multivariable logistic regression models, generalized additive models and subgroup analysis.
UNASSIGNED: The study encompassed 7,063 patients with coexisting diabetes and congestive heart failure. The fully adjusted model revealed an inverse association between serum chloride levels and in-hospital mortality. As a tertile variable (Q3 vs Q1), the odds ratio (OR) was 0.73 with a 95% confidence interval (CI) of 0.54-0.98 (p = 0.039). As a continuous variable, per 1 mmol/L increment, the OR (95% CI) was 0.97 (0.96-0.99, p = 0.01). The relationship between serum chloride and in-hospital mortality demonstrated linearity (non-linear p = 0.958). Stratified analyses further validated the robustness of this correlation.
UNASSIGNED: Serum chloride levels exhibited a negative association with in-hospital mortality in patients with both congestive heart failure and diabetes. Nevertheless, prospective, randomized, controlled studies are warranted to corroborate and validate the findings presented in this investigation.
摘要：
充血性心力衰竭（CHF）在重症监护病房内的糖尿病患者中患病率升高。在危重患者中经常观察到氯化物水平异常的发生，然而，其临床意义仍有待辩论。这项研究试图探讨充血性心力衰竭和糖尿病患者的血清氯化物水平与住院死亡率之间的关系。
■进行了一项回顾性队列研究，利用来自重症监护医疗信息集市(MIMIC-IV)数据库的数据，专注于美国的成年患者。使用多变量logistic回归模型分析ICU入院时血清氯化物水平对住院死亡率的影响，广义加法模型和子群分析。
■该研究涵盖了7,063名患有糖尿病和充血性心力衰竭的患者。完全校正的模型揭示了血清氯化物水平与住院死亡率之间的负相关。作为三元变量(Q3与Q1)，比值比(OR)为0.73,95%置信区间(CI)为0.54~0.98(p=0.039).作为连续变量，每增加1mmol/L，OR（95%CI）为0.97（0.96-0.99，p=0.01）。血清氯化物与住院死亡率之间的关系呈线性关系（非线性p=0.958）。分层分析进一步验证了这种相关性的鲁棒性。
■在充血性心力衰竭和糖尿病患者中，血清氯化物水平与住院死亡率呈负相关。然而，prospective,随机化，有必要进行对照研究,以证实和验证本次调查的结果.
■进行了一项回顾性队列研究，利用来自重症监护医疗信息集市(MIMIC-IV)数据库的数据，专注于美国的成年患者。使用多变量logistic回归模型分析ICU入院时血清氯化物水平对住院死亡率的影响，广义加法模型和子群分析。
■该研究涵盖了7,063名患有糖尿病和充血性心力衰竭的患者。完全校正的模型揭示了血清氯化物水平与住院死亡率之间的负相关。作为三元变量(Q3与Q1)，比值比(OR)为0.73,95%置信区间(CI)为0.54~0.98(p=0.039).作为连续变量，每增加1mmol/L，OR（95%CI）为0.97（0.96-0.99，p=0.01）。血清氯化物与住院死亡率之间的关系呈线性关系（非线性p=0.958）。分层分析进一步验证了这种相关性的鲁棒性。
■在充血性心力衰竭和糖尿病患者中，血清氯化物水平与住院死亡率呈负相关。然而，prospective,随机化，有必要进行对照研究,以证实和验证本次调查的结果.
