Use of the logistic organ dysfunction system to study mortality in an Indian intensive care unit

Mortality in Indian intensive care units has not been well studied. Scoring systems are used to predict mortality of patients admitted to such units. Some scoring systems predict hospital mortality while others predict mortality in intensive care units. We used the logistic organ dysfunction system to study the hospital and intensive care unit mortalities in our intensive care unit.

We prospectively studied 527 consecutively admitted patients in 1997 to the medical intensive care unit in St John's Medical College Hospital, Bangalore. The outcomes studied were death in hospital and death in the intensive care unit. Using standardized mortality ratios, we compared our observed hospital and intensive care unit mortalities with the hospital mortality predicted by the logistic organ dysfunction system.

The standardized mortality ratios for hospital deaths was 1.3 with a confidence interval of 1.17-1.49 and for intensive care unit deaths it was 1.0 with a confidence interval of 0.89-1.18. The hospital mortality rates in our setting are significantly higher (p < 0.05) than the predicted hospital mortality rates of the published western model for intensive care unit patients. The intensive care unit mortality rates are not significantly different from the predicted hospital mortality rates of the published western model for intensive care unit patients.

Our intensive care unit mortality rate is comparable to the western hospital mortality rate. However, after transfer of patients out of the unit, the hospital mortality is higher.