Abstract
Predicting the clinical progression of intensive care unit (ICU) patients is crucial for survival and prognosis. Therefore, this retrospective study aimed to develop the risk scoring system of mortality and the prediction model of ICU length of stay (LOS) among patients admitted to the ICU. Data from ICU patients aged at least 18 years who received parenteral nutrition support for ≥50% of the daily calorie requirement from February 2014 to January 2018 were collected. In-hospital mortality and log-transformed LOS were analyzed by logistic regression and linear regression, respectively. For calculating risk scores, each coefficient was obtained based on regression model. Of 445 patients, 97 patients died in the ICU; the observed mortality rate was 21.8%. Using logistic regression analysis, APACHE II score (15–29: 1 point, 30 or higher: 2 points), qSOFA score ≥ 2 (2 points), serum albumin level < 3.4 g/dL (1 point), and infectious or respiratory disease (1 point) were incorporated into risk scoring system for mortality; patients with 0, 1, 2–4, and 5–6 points had approximately 10%, 20%, 40%, and 65% risk of death. For LOS, linear regression analysis showed the following prediction equation: log(LOS) = 0.01 × (APACHE II) + 0.04 × (total bilirubin) − 0.09 × (admission diagnosis of gastrointestinal disease or injury, poisoning, or other external cause) + 0.970. Our study provides the mortality risk score and LOS prediction equation. It could help clinicians to identify those at risk and optimize ICU management.
Highlights
In the era of the COVID-19 pandemic, a large number of patients with respiratory distress or failure are admitted to the hospital and intensive care unit (ICU) [1,2,3]
A total of 1179 patients were enrolled, and 734 patients were excluded for the following reasons: staying less than 4 days (n = 325), with ≥50% of the daily calorie requirement supported by enteral nutrition (EN) or oral intake (n = 223), with cancer or human immunodeficiency virus (HIV) infection (n = 181), and with duplicate records of staying in medical and surgical ICUs (n = 5)
Among the diagnoses on admission, respiratory and infectious diseases were significant factors associated with mortality
Summary
In the era of the COVID-19 pandemic, a large number of patients with respiratory distress or failure are admitted to the hospital and intensive care unit (ICU) [1,2,3]. It is well known that patients admitted to the ICU need more hospital resources and intensive care provided by medical staff compared with patients admitted to general wards [8,9]. This can be attributed to the heterogeneous nature of their diseases, including major trauma, burn, major surgery, severe distress in the respiratory system or other organs, and critical infection, which is often presented as sepsis or septic shock [10,11,12,13]. Predicting clinical progression and providing appropriate treatment are crucial for the survival and prognosis of these critically ill patients [15,16,17,18]
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