SynthesisFrontiers in medicine2026
Low serum chloride concentration and the in-hospital mortality of patients with acute decompensated heart failure: a meta-analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Hypochloremia is increasingly recognized as a marker of neurohormonal activation and adverse prognosis in acute decompensated heart failure (ADHF). However, the magnitude and consistency of its association with short-term mortality remain uncertain. This meta-analysis aimed to evaluate the relationship between admission serum chloride levels and in-hospital mortality among patients hospitalized with ADHF. Methods: PubMed, Embase, and Web of Science were searched for cohort studies reporting the association between admission serum chloride levels and in-hospital mortality in ADHF. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model accounting for the possible influence of heterogeneity. Results: Seven studies comprising eight independent cohorts and 17,239 ADHF patients were included. Overall, 2,422 (14.0%) had admission hypochloremia, and 1,242 (7.2%) died during hospitalization. Hypochloremia was associated with significantly higher in-hospital mortality (RR: 2.24, 95% CI: 1.60-3.13, Conclusion: Admission hypochloremia is associated with higher in-hospital mortality in patients with ADHF. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier registration number CRD420251275904.
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