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Table 1 Characteristics of patients with and without perioperative hyperchloremia (Cl− ≥ 110 mmol·L− 1)

From: Hyperchloremia and postoperative acute kidney injury: a retrospective analysis of data from the surgical intensive care unit

Variables

Perioperative hyperchloremia (n = 1876, 23.5%)

No perioperative hyperchloremia (n = 6115, 76.5%)

P value

Preoperative characteristics

 Male sex

1091 (58.2%)

3636 (59.5%)

0.315

 Age, years

58.0 (15.7)

62.1 (15.6)

<0.001

 Body mass index, kg m−2

23.5 (3.6)

23.6 (3.8)

0.240

 Surgery time, min

268.8 (150.9)

220.1 (147.6)

<0.001

 ASA class

  

<0.001

  1

433 (23.1%)

975 (15.9%)

 

  2

892 (47.5%)

3191 (52.2%)

   ≥ 3

551 (29.4%)

1949 (31.9%)

 Cancer

405 (21.6%)

1840 (30.1%)

<0.001

 eGFR*a, mL·min− 1·1.73·m−2

  

0.313

   ≥ 90

841 (44.8%)

2596 (42.5%)

 

  60–89

528 (28.1%)

1825 (29.8%)

 

  30–60

310 (16.5%)

1029 (16.8%)

 

   < 30

197 (10.5%)

665 (10.9%)

 

Intraoperative characteristics

 Type of operation

  

<0.001

  Non-cardiovascular surgery

1567 (83.5%)

4786 (78.3%)

 

  Cardiovascular surgery

309 (16.5%)

1329 (21.7%)

 

 Emergency surgery

329 (17.5%)

781 (12.8%)

<0.001

 Intraoperative hypotensionb

455 (24.3%)

1659 (27.1%)

0.013

 Type of anesthesia

  

<0.001

  General anesthesia

1823 (97.5%)

5474 (89.9%)

 

  Regional anesthesia

23 (1.2%)

278 (4.6%)

 

  Monitored anesthesia care

24 (1.3%)

335 (5.5%)

 

Patient management (PODs 0–3)

 NaCl 0.9% infused, mL kg−1

12.3 (13.2)

8.4 (9.5)

<0.001

 NaCl 0.45% infused, mL kg− 1

6.5 (20.3)

2.9 (12.9)

<0.001

 Balanced electrolyte solution infused, mL kg−1

41.9 (37.1)

49.7 (40.7)

<0.001

 Free water containing dextrose, mL kg−1

47.2 (62.5)

59.3 (56.9)

<0.001

 Hydroxyethyl starch infused, mL kg−1

22.1 (21.5)

13.4 (16.5)

<0.001

 Intraoperative fluid balance, %c

1.8 (3.6)

1.7 (2.8)

0.321

 RRT (without RRT history)

51 (2.7%)

135 (2.2%)

0.199

 Use of inotropes/vasopressorsd

1635 (87.2%)

4286 (70.1%)

<0.001

 Use of diureticse

1300 (69.3%)

3423 (56.0%)

<0.001

 Use of radiocontrast

991 (52.8%)

1738 (28.4%)

<0.001

 Use of nephrotoxic antibioticsf

377 (20.1%)

1147 (18.8%)

0.197

 Use of NSAIDs

754 (40.2%)

2194 (35.9%)

0.001

Postoperative laboratory (PODs 0–3) and clinical outcomes

 Maximum Cl−, mmol/L*

112.3 (2.9)

104.8 (3.3)

<0.001

 Increase in Cl−, mmol/L**

5.6 (4.4)

3.5 (3.2)

<0.001

 Postoperative metabolic acidosis (PODs 0–3)

262 (14.0%)

615 (10.1%)

<0.001

 AKI occurrence

289 (15.4%)

898 (14.7%)

0.443

   AKI stage ≥ 2 occurrence

51 (2.7%)

135 (2.2%)

0.199

  1. Values are expressed as the mean (standard deviation) or number (percentage)
  2. ASA American Society of Anesthesiologists classification, eGFR estimated glomerular filtration rate, RRT renal replacement therapy, POD postoperative day, NSAID nonsteroidal anti-inflammatory drug; AKI, acute kidney injury
  3. *Laboratory values within 3 days after operation
  4. **The increase in Cl− or serum sodium levels was calculated as the difference between the preoperative value and the maximum value noted during PODs 0–3
  5. aeGFR (mL·min− 1·1.73·m− 2) = 186 × (Creatinine)-1.154 × (Age)-0.203 (× 0.742 if female)
  6. bIntraoperative hypotension was defined as mean blood pressure < 60 mmHg for > 1 min
  7. cIntraoperative fluid balance (%) = {[Total input fluid (L) – Total output fluid (L)] × 100} × weight on admission− 1 (kg)
  8. dInotropes/vasopressors include norepinephrine, epinephrine, vasopressin, dobutamine, and dopamine
  9. eDiuretics include mannitol and furosemide
  10. fNephrotoxic antibiotics include aminoglycoside, cephalosporin, vancomycin, and sulfonamide
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Critical Care

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