{"id":"45975","type":"article","url":"https://hartvaat.nl/2026/05/20/hypochloremie-bij-opname-voor-acuut-hartfalen-voorspelt-onafhankelijk-30-daagse-/","title":"Hypochloremie bij opname voor acuut hartfalen voorspelt onafhankelijk 30-daagse sterfte (Vietnamees cohort)","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","internist"],"tags":[],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003635?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003635?rss=1","authors":["Tran","D. H.","Truyen","T. T. T. T.","Pham","V. N. A.","Nhut Do","C.-M.","Vo","P. D.","Phan","T. C.","Nguyen Le","H. M.","Tran","H. N. T.","Luu","B. M. T.","Nguyen","T. H.-D.","Tran","T. P.","Nguyen","V. K.","Truong","D. T.","Pham","T. P.","Nguyen","M. V.","Nguyen","M. N."],"significance":5,"published":"2026-07-06","source_date":"2026-05-20","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/wat-is-coronairlijden/","https://hartvaat.nl/kennis/coronairlijden/esc-richtlijn-chronisch-coronairlijden-2024/"],"congress":"","summary_en":"Cross-sectional study at Can Tho Central General Hospital (Vietnam, May-December 2024) in 423 patients ≥18 years with acute heart failure and NT-proBNP ≥300 pg/mL (mean age 69.7 years; 48% male). During hospitalisation, 5.0% died; of 252 discharged patients who completed 30-day phone follow-up, 17.1% died. After adjustment for age, sex, coronary disease, chronic HF, LVEF, and serum sodium, hypochloraemia was an independent predictor of both in-hospital mortality (aOR 4.9; 95% CI 1.3-18.5) and 30-day mortality (aRR 1.9; 95% CI 1.1-3.6). Each 1 mmol/L increase in chloride was associated with 5% lower 30-day mortality (RR 0.95; p=0.007). The findings confirm admission serum chloride as a valuable prognostic biomarker in AHF in a population where Western data are scarce.","created":"2026-07-03T20:27:00Z","updated":"2026-07-04T19:09:36Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Cross-sectionele studie aan het Can Tho Central General Hospital (Vietnam, mei-december 2024) bij 423 patiënten ≥18 jaar met acuut hartfalen en NT-proBNP ≥300 pg/mL (gemiddelde leeftijd 69,7 jaar; 48% man). Tijdens opname overleed 5,0%; van de 252 ontslagen patiënten die de 30-daagse follow-up via telefonisch interview voltooiden, overleed 17,1%. Na correctie voor leeftijd, geslacht, coronairlijden, chronisch hartfalen, LVEF en serum-natrium was hypochloremie een onafhankelijke voorspeller van zowel in-hospital mortaliteit (aOR 4,9; 95%-BI 1,3-18,5) als 30-daagse mortaliteit (aRR 1,9; 95%-BI 1,1-3,6). Elke 1 mmol/L toename van chloride was geassocieerd met 5% lager 30-daags sterfterisico (RR 0,95; p=0,007). Het bevestigt serum-chloride bij opname als waardevol prognostisch biomarker bij AHF in een populatie waar Westerse data schaars zijn.","abstract_original":"Introduction\n

Serum chloride has been recently recognised as a predictor of short-term mortality in patients hospitalised with acute heart failure (AHF). However, data from developing nations such as Vietnam remain limited.

\n\nMethods\n

We conducted a cross-sectional study at Can Tho Central General Hospital, Vietnam, from May to December 2024. Adult patients aged ≥18 years, hospitalised with AHF and NT-proBNP levels ≥300 pg/mL, were included after providing informed consent. Exclusions were made for patients lacking 24-hour electrolyte panels, those transferred or deceased before blood collection and individuals with end-stage renal disease, on renal replacement therapy or with active malignancies. Postdischarge survivors were followed up via phone interviews for 30 days. The primary endpoint was all-cause mortality. Given the low in-hospital event rate (5%), logistic regression was used to estimate ORs, while modified Poisson regression with robust variance estimation was applied for 30-day mortality, where the event rate exceeded 10% and OR would overestimate true risk.

\n\nResults\n

The final cohort included 423 patients (mean age 69.7±12.7 years; 48% male). During hospitalisation, 21 (5.0%) patients died and 402 were discharged alive. Of the discharged patients, 252 (62.7%) completed a 30-days follow-up, with 43 deaths (17.1% mortality rate). After adjusting for age, sex, coronary artery disease, chronic heart failure, left ventricular ejection fraction and serum sodium, hypochloraemia was an independent predictor of in-hospital mortality (adjusted OR 4.9; 95% CI 1.3 to 18.5) and 30-days mortality (adjusted RR 1.9; 95% CI 1.1 to 3.6). Additionally, each 1 mmol/L increase of chloride was associated with a 5% lower risk of 30-day death (RR per unit change 0.95; 95% CI 0.91 to 0.99; p=0.007).

\n\nConclusion\n

Admission serum chloride levels independently predicted both in-hospital and 30-days all-cause mortality in Vietnamese patients with AHF. Including this biomarker in risk-stratification tools could enhance short-term prognostication, while its longer-term predictive value warrants further investigation.

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