J Med Assoc Thai 2003; 86 (1):8

Views: 893 | Downloads: 20 | Responses: 0

PDF XML Respond to this article Print Alert & updates Request permissions Email to a friend


Risk Factors for Predicting Mortality in a Surgical Intensive Care Unit in the Year 2000
Bunburaphong P Mail, Chatrkaw P , Ultchaswadi P , SumethaAksorn N

PHORNLERT CHATRKAW,MD*,
KAEW SUPLEORNSUG, MD*,
NAREERAT SUMETHA-AKSORN, MD*
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
2
-blocker (AOR, 0.2; 95% CI, 0.1 to 0.5; p
=
0.001) were
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.
Key word
: Risk Factor, Mortality, Surgical, Intensive Care Unit
BUNBURAPHONG P, CHATRKA W P, SRIPRACHITTICHAI P

Download: PDF