Clinical, Laboratory, Infectious, and Intervention Factors Associated with ICU Mortality: A Retrospective Cohort...

Area of Science:

• Critical Care Medicine
• Public Health
• Epidemiology

Background:

• Intensive care unit (ICU) mortality is a complex outcome influenced by patient vulnerability, physiological status, hospital-acquired infections, and treatment intensity.
• Understanding the multifactorial nature of ICU mortality is crucial for improving patient outcomes and resource allocation.

Purpose of the Study:

• To investigate the factors associated with mortality in adult patients admitted to the ICU.
• To identify key predictors of ICU non-survival through a retrospective cohort analysis.

Main Methods:

• A retrospective cohort study of 3323 adult first ICU admissions was conducted at a single center.
• Patients were categorized into survivors and non-survivors, and data were analyzed using statistical tests and logistic regression.
• Exclusion criteria included secondary admissions, patients under 18, and pregnancy admissions.

Main Results:

• The overall ICU mortality rate was 46.5%, with 28-day ICU mortality at 40.2%.
• Non-survivors were significantly older and had higher prevalence of comorbidities like hypertension, diabetes, COVID-19, and cardiovascular/renal diseases.
• Adjusted logistic regression identified age, COVID-19, ventilator-associated pneumonia, elevated lactate, low pH, mechanical ventilation, CPR, renal replacement therapy, and acid-base disorders as significant predictors of mortality.

Conclusions:

• ICU non-survival is associated with advanced age, COVID-19, pre-existing cardiovascular and renal conditions, ICU-acquired infections, and metabolic derangements.
• Early initiation of organ support interventions is also linked to increased mortality risk.
• Findings highlight the complex interplay of factors contributing to ICU mortality, emphasizing the need for comprehensive patient management.