Serum Chloride Levels Linked to Prognosis in Hepatic Coma Patients

Background: Hepatic coma, or hepatic encephalopathy, significantly contributes to mortality in patients with liver failure, with nearly 50% of such patients experiencing this severe complication. Existing management strategies for these patients have limited success, highlighting a pressing need for more effective prognostic indicators.

Method: This study was a retrospective cohort analysis involving 150 ICU patients diagnosed with hepatic coma. Serum chloride levels were measured at admission and analyzed alongside clinical outcomes. The primary endpoint was 30-day mortality, and statistical analyses included multivariate logistic regression adjusting for confounders.

Results: Elevated serum chloride levels (> 108 mEq/L) were associated with a 45% increase in 30-day mortality (odds ratio 2.1, 95% confidence interval 1.5 - 3.0, P<0.001). Additionally, the mean serum chloride level in non-survivors was 111 mEq/L compared to 105 mEq/L in survivors (P<0.005). Safety events related to chloride levels did not exceed 10% of cases.

Conclusion: This study suggests that serum chloride levels may serve as a reliable prognostic marker in patients with hepatic coma, potentially guiding clinical decision-making in ICU settings. Future research should further validate these findings in larger, multicenter studies and explore their implications in treatment protocols.

Original citation address: https://www.besjournal.com/en/article/doi/10.3967/bes2025.092