Aras Zülküf, Paşalı Kilit Türkan
Internal Medicine, Kütahya University of Health Sciences, Kütahya, TUR.
Cureus. 2024 Dec 28;16(12):e76522. doi: 10.7759/cureus.76522. eCollection 2024 Dec.
The mortality risk for critically ill patients in the intensive care unit (ICU) can be predicted through clinical assessments and laboratory test results. The accurate utilization of these parameters is essential for timely intervention and the initiation of appropriate therapeutic strategies. This study aims to retrospectively examine the relationship between patients' clinical status at ICU admission, prognostic risk scoring systems, biochemical and hematological parameters, and mortality outcomes.
This descriptive, cross-sectional, retrospective cohort study was conducted in the Internal Medicine Intensive Care Unit of Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital, Turkey, between July 1, 2018, and July 30, 2020, and included a total of 490 patients. The initial admission data, encompassing variables such as gender, age, chronic conditions, reasons for ICU admission, ICU length of stay, total hospital stay, requirement for mechanical ventilation (MV), Nutrition Risk Screening 2002 (NRS-2002) score, hemogram, and biochemical parameters, were recorded. The clinical and demographic characteristics, along with the initial laboratory values of patients who either died or were discharged from the ICU, were subjected to statistical analysis.
Of the 490 patients, 258 were male, and 232 were female, with a median age of 72 (63-80). Of the 490 patients, 211 (43.1%) died, while 279 (46.6%) were discharged from the ICU. Logistic regression analysis showed that MV requirement, NRS-2002 score, lactate, and red cell distribution width (RDW-CV) were independent predictors of mortality (p < 0.05). MV requirement had the highest odds ratio.
In both multivariate analysis and clinical practice, the independent predictors of mortality in ICU patients were identified as the need for MV, elevated NRS-2002 scores, increased lactate levels, and higher RDW-CV values. Among these, the strongest predictor of mortality was the requirement for MV. We anticipate that the results of our study will aid in the enhancement of mortality prediction models and provide important parameters to inform clinical practice.
通过临床评估和实验室检查结果可预测重症监护病房（ICU）中重症患者的死亡风险。准确利用这些参数对于及时干预和启动适当的治疗策略至关重要。本研究旨在回顾性研究ICU入院时患者的临床状况、预后风险评分系统、生化和血液学参数与死亡结局之间的关系。
本描述性、横断面、回顾性队列研究于2018年7月1日至2020年7月30日在土耳其屈塔希亚健康科学大学埃夫利耶·切莱比培训与研究医院的内科重症监护病房进行，共纳入490例患者。记录了初始入院数据，包括性别、年龄、慢性病、ICU入院原因、ICU住院时间、总住院时间、机械通气（MV）需求、2002年营养风险筛查（NRS-2002）评分、血常规和生化参数等变量。对死亡或从ICU出院患者的临床和人口统计学特征以及初始实验室值进行了统计分析。
490例患者中，男性258例，女性232例，中位年龄为72岁（63 - 80岁）。490例患者中，211例（43.1%）死亡，279例（46.6%）从ICU出院。逻辑回归分析显示，MV需求、NRS-2002评分、乳酸和红细胞分布宽度（RDW-CV）是死亡的独立预测因素（p < 0.05）。MV需求的比值比最高。
在多因素分析和临床实践中，ICU患者死亡的独立预测因素被确定为MV需求、NRS-2002评分升高、乳酸水平升高和RDW-CV值升高。其中，最强的死亡预测因素是MV需求。我们预计本研究结果将有助于改进死亡预测模型，并为临床实践提供重要参数。
