Changes in chloremia, secondary to hydric reanimation during the first 24 hours, increases hospital stay and complications in patients with acute pancreatitis.

Cambios en la cloremia secundaria a la reanimación hídrica, en las primeras 24 horas, incrementa la estancia hospitalaria y las complicaciones en los pacientes con pancreatitis aguda.

• Rafael Silva Olvera Instituto Mexicano del Seguro Social. San Luis Potosí, SLP, México https://orcid.org/0000-0002-3895-1149
• Mauricio Pierdant Pérez Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México. https://orcid.org/0000-0002-4606-0071
• Gustavo Ibarra Cabañas Instituto Mexicano del Seguro Social. San Luis Potosí, SLP, México https://orcid.org/0000-0002-5319-4879
• Iván Ledezma Bautista Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México. https://orcid.org/0000-0003-4747-1777
• Raúl Alejandro Hernández Rocha Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México. https://orcid.org/0000-0002-2395-1736
• Antonio Augusto Gordillo Moscoso Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México. https://orcid.org/0000-0002-7351-4614

DOI: https://doi.org/10.54817/IC.v63n2a03

Keywords: Pancreatitis, chlorides, isotonic solutions, length of stay

Abstract

Acute pancreatitis (AP) requires first-line treatment with intensive fluid resuscitation. Hydroelectrolyte changes secondary to this management could be related to an increase in hospital stay, complications, and mortality. The objective of this study was to correlate the increase in serum chlorine (> 8mEq / L) during the first 24 hours (ISC) with a longer hospital stay, complications and mortality in patients with AP. A total of 110 patients with AP admitted to the emergency room were included. Fluid management and serum chlorine were recorded on admission and after 24 hours; duration of hospital stay, complications and mortality, were also registered. 37 patients had ISC (age 56.4 ± 18.4 years; 51% women), there were no differences in age, sex or type of fluid management with patients without ISC. In bivariate analysis, ISC was associated with severe AP (30% vs 12%, p = 0.02), higher APACHE II score at admission (8 [6-15] vs 6 [4-9] points, p = 0.006), and longer hospital stay (9 [7-12] vs 7 [5-10] days, p = 0.03). The overall mortality and complications rate were 16% and 25%, respectively, with no differences between the groups (24% vs. 12%, p = 0.1 and 35% vs. 19%, p = 0.06). After multivariate adjustment, independent predictors of hospital stay were ISC> 8 mEq / L (p= 0.01) and APACHE II scores at 24 hours (p = 0.02). We conclude that ISC is associated with a longer hospital stay in patients with AP from a second-level hospital care population.

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