Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study.

Autor: Soares Pinheiro FGM; Nursing Department, Federal University of Sergipe, Lagarto, Sergipe, Brazil., Santana Santos E; Graduate Program in Nursing, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Barreto ÍDC; Graduate Program of Biometrics and Applied Statistics, Federal Rural University of Pernambuco, Recife, Brazil., Weiss C; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA., Vaez AC; Nursing Department, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Oliveira JC; Graduate Program in Nursing, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Melo MS; Graduate Program in Nursing, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Silva FA; Graduate Program in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
Jazyk: angličtina
Zdroj: Critical care research and practice [Crit Care Res Pract] 2020 Aug 01; Vol. 2020, pp. 1483827. Date of Electronic Publication: 2020 Aug 01 (Print Publication: 2020).
DOI: 10.1155/2020/1483827
Abstrakt: Background: Mortality in the intensive care unit (ICU) has been associated to an array of risk factors. Identification of risk factors potentially contribute to predict and reduce mortality rates in the ICU. The objectives of the study were to determine the prevalence and the factors associated with the mortality and to analyze the survival.
Method: A cross-sectional study conducted in two clinical and surgical ICU in the state of Sergipe, northeastern Brazil. We enrolled 316 patients with at least 48 h of hospitalization, minimum age of 18 years old, sedated or weaned, with RASS ≥ -3, between July 2017 and April 2018. We categorized data in (1) age and gender, (2) clinical condition, and (3) prevalence of delirium. Data from enrolled patients were collected from enrollment until death or ICU discharge. Patients' outcomes were categorized in (1) death and (2) nondeath (discharge).
Results: Twenty-one percent of participants died. Age (53 ± 17 years vs . 45 ± 18 years, p < 0.01), electrolyte disturbance (30.3% vs 18.1%, p =0.029), glycemic index (33.3% vs 18.2%, p =0.008), tube feeding (83.3% vs 67.1%, p =0.01), mechanical ventilation (50% vs 35.7%, p =0.035), sedation with fentanyl (24.2 vs 13.6, p =0.035), use of insulin (33.8% vs 21.7%, p =0.042), and higher Charlson score (2.61 vs 2.17, p =0.041) were significantly associated with death on the adjusted model. However, the regression model indicated that patients admitted from the emergency (HR = 0.40, p =0.006) and glycemic index alterations (HR = 1.68, p =0.047) were associated with mortality. There was no statistically significant difference ( p =0.540) in survival between patients with and without delirium, based on the survival analysis and length of hospitalization.
Conclusion: The prevalence of death was 21%, and age, electrolyte disturbance, glycemic index, tube feeding, mechanical ventilation, sedation with fentanyl, use of insulin, and higher Charlson score were associated with mortality.
Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper.
(Copyright © 2020 Fernanda G. de M. Soares Pinheiro et al.)
Databáze: MEDLINE
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