Kebede Fetene, Mosisa Getu, Yilma Mekdes
Disease Prevention and Control Department, Jima Arjo District Health Office, Oromia, Ethiopia.
Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
Front Med (Lausanne). 2024 Nov 20;11:1370729. doi: 10.3389/fmed.2024.1370729. eCollection 2024.
In resource-constrained countries, the incidence of mortality among patients admitted to adult intensive care units is higher than that in developed countries, which has a physical, economic, and emotional impact on the lives of patients and their families. However, there is limited evidence on factors related to nursing care that can potentially contribute to predicting and reducing mortality rates in intensive care units. Therefore, this study aimed to assess the incidence of mortality and its predictors in patients admitted to an adult intensive care unit.
A retrospective cohort study was conducted among 403 patients admitted to the adult intensive care unit from 1 January 2021 to 31 December 2021. The collected data were entered into Epi Data Manager v4.6.0.6 and exported to SPSS version 24 for analysis. Binary logistic regression was used to identify the predictors of mortality. Variables with a -value less than 0.25 in bivariable logistic regression were selected for multivariable logistic regression. A -value <0.05 was used to indicate a significant association in multivariable analysis. Finally, the adjusted relative risk (RR) with 95% CI was calculated.
A total of 403 patients were included in the analysis. The cumulative incidence of death was 40.9% (95% CI 36, 45.9%). Mortality was significantly associated with the need for mechanical ventilation (adjusted RR = 1.45; 95% CI: 1.04, 1.85), the Glasgow Coma Scale score < 8 (adjusted RR, 3.52; 95% CI: 2.90, 4.05), presence of comorbidity (adjusted RR, 1.47; 95% CI: 1.09, 1.83), length of stay in ICU < 24 h (adjusted RR, 1.84; 95% CI: 1.37, 2.04), oxygen saturation level, and Feeding, Analgesia, Sedation, Thrombosis prophylaxis, Head elevation, Ulcer prophylaxis, and Glucose control (FASTHUG) treatment received were significantly associated with mortality.
The study found a high incidence proportion of death. The need for mechanical ventilation, length of stay, comorbidity, and the Glasgow Coma Scale score were significantly associated with mortality. Therefore, close monitoring and evaluation of patients are essential to improve treatment outcomes.
在资源有限的国家,入住成人重症监护病房的患者死亡率高于发达国家,这对患者及其家庭的生活产生了身体、经济和情感上的影响。然而,关于护理相关因素对预测和降低重症监护病房死亡率可能有贡献的证据有限。因此,本研究旨在评估入住成人重症监护病房患者的死亡率及其预测因素。
对2021年1月1日至2021年12月31日入住成人重症监护病房的403例患者进行回顾性队列研究。收集的数据录入Epi Data Manager v4.6.0.6,并导出到SPSS 24版进行分析。采用二元逻辑回归确定死亡率的预测因素。在二元逻辑回归中P值小于0.25的变量被选入多变量逻辑回归。多变量分析中P值<0.05表示有显著关联。最后,计算调整后的相对风险(RR)及95%置信区间。
共403例患者纳入分析。累积死亡率为40.9%(95%置信区间36,45.9%)。死亡率与机械通气需求(调整后RR = 1.45;95%置信区间:1.04,1.85)、格拉斯哥昏迷量表评分<8(调整后RR,3.52;95%置信区间:2.90,4.05)、合并症(调整后RR,1.47;95%置信区间:1.09,1.83)、在重症监护病房停留时间<24小时(调整后RR,1.84;95%置信区间:1.37,2.04)、血氧饱和度水平以及接受的喂养、镇痛、镇静、血栓预防、床头抬高、溃疡预防和血糖控制(FASTHUG)治疗显著相关。
该研究发现死亡发生率较高。机械通气需求、住院时间、合并症和格拉斯哥昏迷量表评分与死亡率显著相关。因此,密切监测和评估患者对于改善治疗结果至关重要。