Association between the use of balanced fluids and outcomes in critically ill children: a before and after study

Table 4 Association between chloride abnormalities and outcomes

Outcomes	Hypochloremia	Normochloremia	Hyperchloremia
Acute kidney injury (day 3) n = 1008
n (%)	24 (17.7%)	74 (10.2%)	32 (22.5%)
Unadjusted OR	1.90 95% CI: 1.14–3.13	Ref	2.57 95% CI: 1.62–4.10
Adjusted OR	2.18 95% CI: 1.26–3.77	Ref	2.32 95% CI: 1.39–3.89
Mortality
n (%)	11 (6.0%)	30 (2.6%)	25 (12.5%)
Unadjusted OR	2.38 95% CI: 1.17–4.84	Ref	5.40 95% CI: 3.10–9.38
Adjusted OR	1.33 95% CI: 0.59–2.99	Ref	2.84 95% CI: 1.46–5.55
Need for renal replacement therapy
n (%)	8 (4.5%)	28 (2.5%)	2 (1.1%)
Unadjusted OR	1.83 95% CI: 0.82–4.07	Ref	0.42 95% CI: 0.10–1.77
Adjusted OR	1.01 95% CI: 0.42–2.46	Ref	0.10 95% CI: 0.02–0.54
Hospital length of stay (days)
Med (IQR)	18.4 (10.6–30.1)	7.7 (4.6–13.9)	8.7 (5–22.5)
Unadjusted IRR	1.69 95% CI: 1.63–1.74	Ref	1.42 95% CI: 1.37–1.47
Adjusted IRR	1.39 95% CI: 1.34–1.43	Ref	1.26 95% CI: 1.21–1.30
Ventilator-free days
Med (IQR)	21 (13–28)	28 (24–28)	27 (17–28)
Unadjusted IRR	0.77 95% CI: 0.74–0.80	Ref	0.84 95% CI: 0.81–0.86
Adjusted IRR	0.89 95% CI: 0.86–0.92	Ref	0.93 95% CI: 0.90–0.96

Hypochloremia was defined as < 98 mmol/L. Normochloremia was defined as 98–109 mmol/L. Hyperchloremia was defined as > 109 mmol/L. Logistic regression analyses were used to evaluate hyperchloremia and hypochloremia in reference to normochloremia with acute kidney injury, mortality, and need for renal replacement therapy adjusting for age, PRISM III score, need for mechanical ventilation, and immunocompromised state. Poisson regression analysis was used to evaluate hyperchloremia and hypochloremia in reference to normochloremia with hospital length of stay and ventilator-free days adjusting for the same confounding variables.

ISSN: 1364-8535