Prognostic role of hypochloremia in acute ischemic stroke patients

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Stroke is the second leading cause of death and adult disability worldwide.1 Identifying and controlling stroke‐related risk factors would be extremely important in the treatment and secondary prevention of stroke.3
Hyponatremia, as a common electrolyte disorder, has been consistently shown to be a predictor of adverse outcomes and mortality in stroke patients.4 Like sodium, serum chloride is another important extracellular anion serving many body functions including the maintenance of osmotic pressure, acid‐base balance, and the movement of water between fluid compartments.9 Recent studies have demonstrated a strong, independent association between lower serum chloride levels or hypochloremia and an increased risk of mortality in heart failure patients.10 Moreover, a greater prognostic role of chloride over sodium was also shown. And the association between lower serum chloride levels and mortality is even more pronounced in chronic kidney disease, hypertensive, and postoperative patients.14
Given the significant role of serum chloride in patients with cardiac disease,10 we hypothesized that it may be also an important prognostic factor for stroke patients. However, the prognostic role of serum chloride in acute ischemic stroke (AIS) patients remains uncertain. In this study, we aimed to evaluate the possible association between hypochloremia and hyponatremia and in‐hospital mortality in a large multicenter study of AIS patients.

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