Risk Factors for Predicting Mortality in a Surgical Inten sive Care Unit in the Year 2000t
PAVENA BUNBURAPHONG, MD*, PHORNLERT CHATRKAW,MD*, PIN SRIPRACHITTICHAI, MD*, KAEW SUPLEORNSUG, MD*, PORNTHIP ULTCHASW ADI, MD*, NAREERAT SUMETHA-AKSORN, MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok I 0330, Thailand. t Presented at the 42'h Annual Academic Meeting of Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 27'h June 2001.
Objective : To determine the mortality and risk factors of mortality in a surgical intensive care unit (SICU), King Chulalongkorn Memorial Hospital.
Design : Review of retrospective data.
Setting : a SICU of a tertiary-care academic medical center. Patients : Out of a total of 546 patients admitted to SICU during a one year period (January I, 2000 - December 31, 2000), 458 (83.9%) had complete medical data which were analyzed. Measurements and Main
Results : One hundred and ninety-three variables of 6 categories of patients' characteristics, chronic disease, acute illness, physiologic variables, therapy and miscella neous were studied. Univariate and multivariate analyses were used. The SICU and hospital morta lity was 8.1 and 14.6 per cent, respectively. Multivariate logistic regression analysis identified seven variables as independent risk factors for mortality (p < 0.05): chronic renal failure (adjusted odds ratio = = IAOR], 7.5; 95% CI, 3.0 to 19.0; p 0.000), coma (AOR, 11.7; 95% CI, 2.4 to 57.4; p 0.002), = Staphylococcus aureus infection (AOR, 15.4; 95% CI, 1.6 to 147.6; p 0.018), diagnosis of systemic inflammatory response (AOR, 2.9; 95% CI, 1.2 to 7.1; p = 0.017), mechanical ventilation (AOR, 11.2; = = 95% CI. 2.0 to 61.4; p 0.005), having received adrenaline (AOR, 7.1; 95% CI, 2.3 to 22.2; p = 0.001) and diuretic (AOR, 3.3; 95% CI, 1.4 to 8.1; p 0.008). Besides weight (AOR, 0.9; 95% CI, = = 0.9 to 1.0; p 0.002) and having received H-blocker (AOR, 0.2; 95% CI, 0.1 to 0.5; p 0.001) were 2 two independent protective factors for mortality.
Conclusion : Knowing the risk factors of SICU mortality wiiJ help physicians to improve patient care, educate patients and their families, optimize ICU resource planning and may decrease health care costs.
Keywords : Risk Factor, Mortality, Surgical, Intensive Care Unit
