Dr. Himanshu Gupta
BACKGROUND Heart failure is commonly associated with electrolyte imbalances. Hyponatraemia has established prognostic role in heart failure, but association of hypochloraemia is still lacking. We wanted to study the impact of admission serum chloride levels in relation to serum sodium levels in 30-day outcomes after hospitalization for acute decompensated heart failure (ADHF). METHODS Total of 405 consecutive patients with diagnosis of ADHF were assessed for serum sodium and serum chloride levels on admission within the period of 2.5 years, and divided into 3 tertiles based on serum chloride levels and observed for 30 day outcome. Continuous variables were compared using independent t-test while ????2 test was used for categorical variables. p-value ≤ 0.05 considered significant. RESULTS Mean age was found to be 62.5 yrs. Overall mortality at 30 days was 24.4% (99) and all deaths occurred in tertile 1 (serum Cl <99), suggesting strong role of hypochloraemia in mortality. Patients in tertiles 2 (99-103) and tertiles 3 (>103) exhibited 100% survival. CONCLUSIONS Mortality at 30 days in patients with ADHF is 24.4 percent and serum chloride is strongly and independently associated with poor survival in these patients and has a major contribution in the risk caused due to hyponatraemia.