BSP collaborative research identifies association between administered intravenous chloride load and in-hospital mortality rate in patients with SIRS


Limiting the amount of chloride administered via intravenous fluids to patients with systemic inflammatory response syndrome (SIRS) may lower their in-hospital mortality rate according to a study by a team which included Boston Strategic Partners, Inc. (BSP) researchers.  The study, ‘Association between intravenous chloride load during resuscitation and in-hospital mortality among patients with SIRS’ was published in the September 2014 issue of Intensive Care Medicine.

SIRS can manifest in up to one-third of all hospital inpatients, more than 50% of all Intensive Care Unit patients and more than 80% of surgical ICU patients.  Depending on the patient’s setting, the SIRS mortality rate can range from 10% to 60%.  As part of the intervention for SIRS, patients are frequently administered large volumes of intravenous fluids which contain varying levels of chloride.

The study found that the mortality rate was lowest among patients who received intravenous fluids with lower concentrations of chloride and that the mortality rate went up as the concentration of chloride increased.  Data from nearly 110,000 patients afflicted with SIRS was analyzed by the BSP team in the study by utilizing the  Cerner HealthFacts® 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. Protected Health Information (PHI) which could specifically identify a patient (like name, address, or social security number) is not included in the Cerner HealthFacts®  database.

The BSP team comprised of Dr. Fred Peyerl, Partner, Dr. Sibyl Munson, Principal, and Dr. Scott Paluszkiewicz, Consultant, working in concert with Dr. Andrew Shaw of Vanderbilt University Medical Center, Dr. Karthik Raghunathan of Duke University Medical Center, and Dr. Carol R. Schermer, Medical Director, Drugs and Solutions at Baxter Health Care.

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About BSP

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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