Introduction:

Hyperchloremia in neurocritical patients is common and has been associated with multiple unfavorable outcomes.

Objective:

To establish the relationship between serum level of hyperchloremia and short-term mortality in neurosurgical patients after elective resection of intracranial tumor.

Material and methods:

A retrospective, observational, comparative, longitudinal study was carried out in the intensive care unit of a tertiary hospital in northern Mexico. Data were obtained from adult patients who underwent an elective neurosurgery procedure for resection of an intracranial tumor mass from January 1,2016 to December 31, 2018 and who spent at least 24 hours postoperatively in the ICU. The patients were classified according to the highest level of serum chloride in the first 24 hours. End point was mortality within 30 days of admission.

Results:

122 patients were included, median age was 48.7 years (20-84); 65 males (53%). Hyperchloremia in the first 24 hours after procedure was detected in 61 patients (50%). Twelve (19.6%) subjects showed hyperchloremia and died in the first 30 days after the procedure. Mean chloride level in the whole population was 110.47 ± 4.7 mmol/L. There was a prevalence in the whole group of 50% of hyperchloremia in the immediate post-operative period, of which 12 died during the next 30 day. There was a marked increase in serum chloride levels in the mortality group (12 of 20 cases, 60%) vs the non-mortality group (49 of 102 cases, 48%) without achieving a significant correlation (p = 0.32). There was no significant correlation between the presence of hyperchloremia as a continuous (p = 0.35) or categorical variable in the immediate postoperative period and mortality at 30 days.

Conclusions:

Serum hyperchloremia in the first 24 hours in the neurocritical postoperative group is not significantly related to mortality at 30 days.

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