Assessment of Risk Factors for Mortality in Patients in Medical Intensive Care Unit of a Tertiary Hospital
Burhan Sami Kalın, Süleyman Özçaylak, İhsan Solmaz, Jehat Kılıç
Albumin, Comorbidity, Creatinine, Intensive care unit, Mortality
Citation Information :
Kalın BS, Özçaylak S, Solmaz İ, Kılıç J. Assessment of Risk Factors for Mortality in Patients in Medical Intensive Care Unit of a Tertiary Hospital. Indian J Crit Care Med 2022; 26 (1):49-52.
Background: Knowing the risk factors for patients in intensive care units (ICUs) facilitates patient's management. The goal of this study was to determine the risk agents that influence our medical ICU mortality.
Patients and methods: This 11-month retrospective trial was managed in the medical ICU. In this study, 340 patients who were followed up for at least 24 hours in ICUs were accepted. The clinical data on patients were recorded retrospectively, and the mortality-related factors were analyzed. A regression analysis was also performed to determine the independent risk factors for ICU mortality.
Results: The median age was 73 (53–82) years. The death rate was 23.8%. Length of stay (LOS) in ICU was 3 (2–5) days, and APACHE-II (acute physiologic and chronic health evaluation) score was 19 (13–25). The prevalence of chronic diseases was not dissimilar except acute and chronic renal failures among survivors and deceased patients (p >0.05). Acute and chronic renal failures were higher in deceased patients than in survivors and were statistically important [107 (41.3%) vs 47 (58%), p = 0.008] and 38 (14.7%) vs 22 (27.2%), p = 0.01], respectively. In the binary logistic regression analysis, age, APACHE II score, need for invasive mechanical ventilation (IMV), decreased serum albumin levels, and increased creatinine levels were established to be independent risk factors for death [(OR (odds ratio): 1.045 (1.009–1.081), p = 0.013, OR: 1.076 (21.008–1.150), p = 0.029, OR: 19.655 (6.337–60.963), p = 0.001), OR: 2.673 (1.191–6.024), p = 0.017, OR: 1.422 (1.106–1.831), p = 0.006)], respectively.
Conclusion: The most significant risk agents of death were determined through high APACHE II score, decreased serum albumin levels, and increased creatinine levels.
Siddiqui S. Mortality profile across our intensive care units: a 5-year database report from a Singapore restructured hospital. Indian J Crit Care Med 2015;19(12):726–727. DOI: 10.4103/0972-5229.171401.
Soares Pinheiro FGM, Santana Santos E, Barreto ÍDC, Weiss C, Vaez AC, Oliveira JC, et al. Mortality predictors and associated factors in patients in the intensive care unit: a cross-sectional study. Crit Care Res Pract 2020;2020:1483827. DOI: 10.1155/2020/1483827.
Altıay G, Tabakoğlu E, Özdemir L, Tokuç B, Çevirme L, Hatipoğlu ON, et al. Solunum Yoğun Bakım Hastalarında Mortalite Oranları ve İlişkili Faktörlerin Belirlenmesi. Toraks Dergisi 2007;8:79–84.
Associação Brasileira de Medicina Intensiva. 2019. Available from: http://www.utisbrasileiras.com.br.
Çakır E, Kocabeyoğlu GM, Gürbüz Ö, BÖ Sevil, Mutlu NM, ÖT Işıl. Yoğun Bakım Ünitesinde Mortalite Sıklığı ve Risk Faktörlerinin Değerlendirilmesi. Ankara Eğt Arş Hast Derg 2020;53(1):20–24. DOI: 10.20492/aeahtd.537879.
Mukhopadhyay A, Tai BC, See KC, Ng WY, Lim TK, Onsiong S, et al. Risk factors for hospital and long-term mortality of critically ill elderly patients admitted to an Intensive Care Unit. Biomed Res Int 2014;2014:960575. DOI: 10.1155/2014/960575.
Wang M, Jiang L, Zhu B, Li W, Du B, Kang Y, et al. The prevalence, risk factors, and outcomes of sepsis in critically ill patients in China: a multicenter prospective cohort study. Front Med (Lausanne) 2020;7:593808. DOI: 10.3389/fmed.2020.593808.
Magro B, Zuccaro V, Novelli L, Zileri L, Celsa C, Raimondi F, et al. Predicting in-hospital mortality from coronavirus disease 2019: a simple validated app for clinical use. PLoS One 2021;16(1):e0245281. DOI: 10.1371/journal.pone.0245281.
Zou X, Li S, Fang M, Hu M, Bian Y, Ling J, et al. Acute physiology and chronic health evaluation ii score as a predictor of hospital mortality in patients of coronavirus disease 2019. Crit Care Med 2020;48(8):e657–e665. DOI: 10.1097/CCM.0000000000004411
Qu R, Hu L, Ling Y, Hou Y, Fang H, Zhang H, et al. C-reactive protein concentration as a risk predictor of mortality in intensive care unit: a multicenter, prospective, observational study. BMC Anesthesiol 2020;20(1):292. DOI: 10.1186/s12871-020-01207-3.
Van Den Noortgate N, Vogelaers D, Afschrift M, Colardyn F. Intensive care for very elderly patients: outcome and risk factors for inhospital mortality. Age Ageing 1999;28(3):253–256. DOI: 10.1093/ageing/28.3.253.
Ng JH, Hirsch JS, Hazzan A, Wanchoo R, Shah HH, Malieckal DA, et al. Outcomes among patients hospitalized with COVID-19 and acute kidney injury. Am J Kidney Dis 2020:S0272-6386(20)30998-7. DOI: 10.1053/j.ajkd.2020.09.002.
Snipelisky D, Jentzer J, Batal O, Dardari Z, Mathier M. Serum albumin concentration as an independent prognostic indicator in patients with pulmonary arterial hypertension. Clin Cardiol 2018;41(6):782–787. DOI: 10.1002/clc.22954.
Chen CW, Chen YY, Lu CL, Chen SC, Chen YJ, Lin MS, et al. Severe hypoalbuminemia is a strong independent risk factor for acute respiratory failure in COPD: a nationwide cohort study. Int J Chron Obstruct Pulmon Dis 2015;10:1147–1154. DOI: 10.2147/COPD.S85831.
Moon JJ, Kim Y, Kim DK, Joo KW, Kim YS, Han SS. Association of hypoalbuminemia with short-term and long-term mortality in patients undergoing continuous renal replacement therapy. Kidney Res Clin Pract 2020;39(1):47–53. DOI: 10.23876/j.krcp.19.088.
Xie M, Li N, Qiao H, Guo JF, Li SL. Acute kidney injury diagnosed by elevated serum creatinine increases mortality in ICU patients following non-cardiac surgery. Zhonghua Yi Xue Za Zhi 2020;100(42): 3285–3290. DOI: 10.3760/cma.j.cn112137-20200318-00824.