A retrospective study of the predictors of mortality among patients in intensive care units at North West-Bank hospitals in Palestine

Abstract

ABSTRACT Objectives The intensive care unit (ICU) mortality rate remains high, especially in developing countries, regardless of the advances in critical management. There is a lack of studies about mortality causes in hospitals and particularly ICUs in Palestine. This study evaluated the demographic and clinical characteristics of critically ill patients and determined the predictors of mortality among patients in the ICU. Methods A retrospective study assessed all patients who stayed in the ICU for more than 24 h from January 2017 to January 2019. Data were collected from the patient’s files. Patient characteristics (background, clinical variables, and comorbidities) were recorded. Results The study included 227 eligible ICU patients. The cases’ mean age was 55.5 (SD ± 18.2) years. The overall ICU mortality rate was 31.7%. The following factors were associated with high adjusted mortality odds: admission from inside the hospital (adjusted odds ratio (aOR), 2.1, 95% CI: 1.1–3.9, p < 0.05), creatinine level ≥2 mg/dl on admission (aOR, 2.7, 95% CI: 1.3–5.8, p < 0.01), hematology malignancy patients (aOR, 3.4, 95% CI: 1.6–6.7, p = 0.001), immune-compromised (aOR, 2.5, 95% CI: 1.3–4.7, p < 0.01), septic shock (aOR, 27.1, 95% CI: 7.9–88.3, p < 0.001), hospital-acquired infections (aOR: 13.4, 95% CI: 4.1–57.1, p < 0.001), and patients with multiple-source infection (aOR: 16.3, 95% CI: 6.4–57.1, p < 0.001). Also, high SOFA and APACHE scores predicted morality (p < 0.001). Conclusion The mortality rate among ICU patients was high. It was higher among those admitted from the hospital wards, septic shock, hospital-acquired infection, multiple infection sources, and multi-drug resistance infections. Thus, strategies should be developed to enhance the ICU environment and provide sufficient resources to minimize the effects of these predictors.