ASSESSMENT OF THE ASSOCIATION OF PREDICTORS OF MORTALITY IN MECHANICALLY VENTILATED PATIENTS

Abstract

Background: Mechanically ventilated patients constitute a high-risk population in intensive care units (ICUs), where a combination of clinical, physiological, and demographic variables frequently determines mortality. Early identification of these predictors is critical to inform therapeutic strategies and improve survival outcomes. Objective: To determine the association of clinical, physiological, and demographic parameters with mortality among patients receiving invasive mechanical ventilation in a tertiary care ICU in Pakistan. Study Design: Descriptive cross-sectional study. Settings: Chest Intensive Care Unit, Gulab Devi Teaching Hospital, Lahore, Pakistan. Duration of Study: August 2023 to January 2024. Methods: A total of 60 adult patients (aged <70 years) who underwent invasive mechanical ventilation were enrolled through non-probability convenience sampling. Demographic characteristics, comorbidities, clinical diagnosis, and indications for intubation were recorded. Post-intubation parameters—including arterial pH, PaO₂/FiO₂ ratio, and Richmond Agitation-Sedation Scale (RASS) scores—were analyzed. The primary endpoint was in-hospital mortality. Statistical analysis was performed using SPSS version 26, with a significance threshold of p<0.05. Results: The in-hospital mortality rate was 75% (n=45), while 25% (n=15) of patients were successfully extubated. No significant correlation was found between mortality and demographic factors such as age (p=0.257), gender (p=0.620), or weight (p=0.389). However, significant predictors of mortality included the underlying reason for intubation (p=0.019), particularly low Glasgow Coma Scale scores and cardiac arrest. Comorbid conditions such as diabetes mellitus (p=0.015) and cardiac disease (p=0.030) were also significantly associated with mortality. Moreover, post-intubation arterial pH (p=0.021), PaO₂/FiO₂ ratio (p=0.021), and RASS scores (p=0.000) demonstrated strong associations with adverse outcomes. Conclusion: The etiology of intubation, pre-existing comorbidities, and early post-intubation physiological parameters significantly influence mortality among mechanically ventilated patients. Proactive recognition and targeted management of these predictors may enhance survival outcomes in critically ill ventilated patients.