INTENSIVE CARE UNIT PATIENTS’ MORTALITY INDICATORS AND ASSOCIATED PARAMETERS

R PERVAIZ; SZ BUKHARI; LH ISSA; H AHMED; T SAGHEER; A QURBAN; R RASHEED; . ADEEL; . ARISH

doi:10.54112/pjicm.v3i01.28

Authors

R PERVAIZ Department of Internal & Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
SZ BUKHARI Department of Critical Care Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
LH ISSA Department of Critical Care Medicine, Mediclinic City Hospital, Dubai, UAE
H AHMED Department of Internal & Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
T SAGHEER Department of Internal & Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
A QURBAN Department of Internal & Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
R RASHEED Department of Internal & Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
. ADEEL Department of Critical Care Nursing, Bahria International Hospital, Lahore, Pakistan
. ARISH Department of Critical Care Nursing, Bahria International Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v3i01.28

Keywords:

Age Factors, Charlson Comorbidity Index, Delirium, Glycemic Index, Intensive Care Units, Mechanical Ventilation, Mortality, Sepsis.

Abstract

Background: Several risk factors have been associated with the intensive care unit (ICU) mortality. Identifying these factors can help predict and reduce ICU mortality rates. Objective: To determine the mortality rate, identify contributing factors, and conduct a survival analysis in ICU patients. Study Design: A retrospective cohort study. Setting: Bahria International Hospital Lahore, & Services Institute of Medical Sciences, Lahore. Duration of Study: January 1, 2021, to December 5, 2022. Methods: A retrospective study was conducted in the medical & surgical ICUs. Data on delirium prevalence, socioeconomic status, and clinical conditions were collected retrospectively. The information included patient admission details, ICU diagnoses, hospital stays, presence of pressure ulcers, signs of dehydration, fluid balance, urine output, skin conditions, diabetes status, temperature, oro-gastric feeding, and ventilatory support. Patients were divided into two groups based on their hospitalisation outcomes: Group A for patients who died and Group B for those who were discharged/shifted from the ICU. Results: A total of 185 patients met the inclusion criteria. The study found that 18.9% of hospitalisations resulted in death. Patients in the death group were older (54 ± 16 years vs. 46 ± 19 years, p = 0.02) and were more likely to be transferred from hospital units after a sepsis diagnosis (57.1% vs. 20.1%, p = 0.01). Delirium was observed in 54.2% of individuals in the death group compared to 47.3% in the discharge group (p = 0.14). The Charlson score was higher in the death group (2.4 ± 2.78 vs. 1.71 ± 2.41, p = 0.04). Multifactorial analysis using the Cox regression model revealed that patients admitted via the emergency room (HR 0.39, p = 0.007) and those with an abnormal glycemic index (HR 1.71, p = 0.041) had higher odds of dying in the ICU. Conclusion: Older age, medical diagnosis of sepsis, and admission from other hospital units were associated with increased ICU mortality. Additionally, water and electrolyte imbalances, variations in glycemic index with tube feeding, mechanical ventilation, and higher Charlson scores were correlated with increased mortality.

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