article · PLoS ONE
BACKGROUND: Electrolyte disturbances such as hypochloremia are common in patients with acute heart failure (AHF) and may worsen clinical outcomes. However, data from low-resource settings remain limited. Therefore, the aim of this study is to determine the prevalence of hypochloremia among AHF patients, assess its association with length of hospital stay and in-hospital mortality, and identify factors independently associated with its occurrence. OBJECTIVE: To determine the prevalence of hypochloremia among patients admitted with acute heart failure, to assess its non-medication association with length of hospital stay and in-hospital mortality, and to identify factors independently associated with hypochloremia in a resource-limited setting. METHODS: A retrospective observational cohort study of hospitalized patients with acute heart failure, with serum chloride measured at admission was conducted among 260 patients aged ≥16. Data were analysed using SPSS version 26.0. The association between hypochloremia and clinical outcomes, including in-hospital mortality and length of hospital stay, was assessed using the Chi-square test and the Mann-Whitney U test, respectively. Multivariable logistic regression analysis was performed to identify independent predictors of hypochloremia. A p-value of <0.05 was considered statistically significant. RESULTS: The prevalence of hypochloremia was 33.1% (95% CI: 27.4%-39.2%), and hypochloremic patients had significantly longer hospital stays (median: 12 days vs. 8.5 days; p = 0.001) and higher in-hospital mortality (χ² = 8.58; p = 0.003). Multivariate analysis showed that NYHA class IV heart failure [AOR = 6.96; 95% CI: 1.49-32.4; p = 0.014], history of COPD [AOR = 4.94; 95% CI: 1.36-17.9; p = 0.001], hyponatremia [AOR = 2.20; 95% CI: 1.8-9.5; p = 0.001], and hypokalemia [AOR = 4.08; 95% CI: 1.53-10.6; p = 0.004] were significantly associated with hypochloremia. CONCLUSION: In this study hypochloremia at admission was common and associated with higher in-hospital mortality and longer hospital stays. It was more frequently observed in patients with severe heart failure, COPD, hypokalemia and hyponatremia.
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DOI: 10.1371/journal.pone.0344692
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