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Risk factors for intensive care unit admission among COVID-19 patients in the West Bank, Palestine: a retrospective
Danyah Khalid1, Hamzeh Al Zabadi1,2, Jamal Qaddumi3
1Public Health Management, Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine.
Insights
Obesity significantly increases the risk of intensive care unit (ICU) admission for COVID-19 patients in Palestine. Other predictors include white blood cell count and blood urea nitrogen, while random blood sugar was inversely associated with ICU admission.
Area of Science:
- Medical Research
- Public Health
- Epidemiology
Background:
- COVID-19 has severely impacted global healthcare systems, especially in resource-limited regions like Palestine.
- Understanding intensive care unit (ICU) admission risk factors is crucial for effective patient triage and resource management in such settings.
Purpose of the Study:
- To identify demographic, clinical, and laboratory predictors of ICU admission among hospitalized COVID-19 patients in the West Bank, Palestine.
- To analyze factors influencing the time to ICU transfer.
Main Methods:
- A retrospective cohort study involving 200 adult COVID-19 patients in six Palestinian governmental hospitals (November 2020 - February 2021).
- Utilized bivariate analyses, multivariate logistic regression, and Cox proportional hazards models to identify independent predictors and time-to-event outcomes.
Main Results:
- Obesity (OR=66.7), elevated white blood cell count (OR=1.25), and hospital site were significant positive predictors of ICU admission.
- Lower blood urea nitrogen (OR=0.96) and random blood sugar (OR=0.99) were inversely associated with ICU admission.
- Obesity, low PaO₂, low BUN, low RBS, pregnancy, and pneumonia significantly reduced the time to ICU admission.
Conclusions:
- This study provides the first comprehensive analysis of ICU admission risk factors for COVID-19 patients in Palestine.
- Findings can inform ICU triage protocols and health policies specific to the Palestinian context.
- Results contribute to preparedness for future pandemics or COVID-19 resurgence.
Background:
COVID-19 has significantly strained healthcare systems worldwide, particularly in resource-limited and conflict-affected regions such as Palestine. Understanding the risk factors for intensive care unit (ICU) admission is essential for effective triage and resource allocation.
Objective:
This study aimed to identify demographic, clinical, and laboratory predictors of ICU admission among hospitalized COVID-19 patients in governmental hospitals across the West Bank, Palestine.
Methods:
A retrospective cohort study was conducted across six designated COVID-19 treatment hospitals from November 2020 to February 2021. Medical records of 200 adult patients with PCR-confirmed COVID-19 were reviewed. Patients were grouped based on ICU versus general ward admission. Bivariate analyses, multivariate logistic regression, and Cox proportional hazards models were employed to identify independent predictors of ICU admission and to evaluate the time to ICU transfer.
Results:
Of the 200 patients, 117 (58.5%) were admitted to the ICU. Multivariate logistic regression identified obesity (OR = 66.7, p < 0.001), hospital site (p = 0.001), white blood cell count (OR = 1.25, p = 0.005), and blood urea nitrogen (OR = 0.96, p = 0.007) as significant positive predictors. Random blood sugar (OR = 0.99, p = 0.014) was inversely associated with ICU admission. Kaplan-Meier and Cox-regression analyses further revealed that obesity, low PaO₂, low BUN, low RBS, pregnancy, and pneumonia significantly shortened the time to ICU admission (all p < 0.05). Conversely, age, gender, comorbidities, and chief complaints were not independently associated with ICU admission.
Conclusion:
This is the first study in Palestine to comprehensively evaluate ICU admission risk factors among COVID-19 patients. Our findings can inform ICU triage protocols and help shape evidence-based health policies tailored to the Palestinian context and could establish data base for new similar future pandemics and/or resurge of COVID-19 for better emergency preparedness and intervention measures.
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