BSP collaborative research evaluates the impact of intravenous (IV) fluid composition on outcomes in patients with SIRS


Predominant use of 0.9% saline is associated with significantly increased morbidity and mortality as compared to predominant use of balanced fluids in patients with systemic inflammatory response syndrome (SIRS), according to a new study by a team which included Boston Strategic Partners, Inc. (BSP) researchers.  The propensity-matched cohort study, ‘Impact of intravenous fluid composition on outcomes in patients with systemic inflammatory response syndrome’ has been published in the September 2015 issue of Critical Care.

Fluids with high chloride concentrations such as 0.9% saline have been linked to adverse outcomes in surgery and critical care. As part of the intervention for SIRS, patients are frequently administered large volumes of intravenous fluids which contain varying levels of chloride. There is a lack of knowledge concerning the association between fluid type and outcomes in general hospitalized patients that could assist clinical practitioners in making informed decisions regarding choice of fluid type.

This study observed that in comparison with the calcium-free balanced cohort (1558 patients), the saline cohort (1558 patients) experienced greater in-hospital mortality, increased length of stay, increased frequency of readmission at 60 and 90 days in addition to higher cardiac, infectious, and coagulopathy complication rates.  Data from >1 MM patients afflicted with SIRS was analyzed by the BSP team in the study by utilizing the Cerner HealthFacts® de-identified electronic health record (EHR) database which contains information about 37 million unique patients over a 14 year timeframe. Unlike many claims databases that only provide information about the tests that have been ordered, HealthFacts database contains detailed lab results allowing for associations between quantitative measures and clinical outcomes to be determined.

The BSP team comprised of Dr. Sibyl Munson, Dr. Victor Khangulov and David Hayashida, collaborating with Dr. Andrew Shaw of Vanderbilt University Medical Center, Dr. Dileep Lobo of Queen’s Medical Center, UK, Dr. Carol R. Schermer, former employee of Baxter Health Care and Dr. John Kellum of Center for Critical Care Nephrology at University of Pittsburgh.

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Boston Strategic Partners, Inc. is a leading global healthcare consulting firm offering services to the life sciences industry in the areas of Business and Clinical Strategy, Health Economics and Outcomes research (HEOR) and Medical & Technical Communications.
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