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

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...

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Main Authors: Fernanda G. de M. Soares Pinheiro, Eduesley Santana Santos, Íkaro Daniel de C. Barreto, Carleara Weiss, Andreia C. Vaez, Jussiely C. Oliveira, Matheus S. Melo, Francilene A. Silva
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/1483827
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author Fernanda G. de M. Soares Pinheiro
Eduesley Santana Santos
Íkaro Daniel de C. Barreto
Carleara Weiss
Andreia C. Vaez
Jussiely C. Oliveira
Matheus S. Melo
Francilene A. Silva
author_facet Fernanda G. de M. Soares Pinheiro
Eduesley Santana Santos
Íkaro Daniel de C. Barreto
Carleara Weiss
Andreia C. Vaez
Jussiely C. Oliveira
Matheus S. Melo
Francilene A. Silva
author_sort Fernanda G. de M. Soares Pinheiro
collection DOAJ
description 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.
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spelling doaj-art-b5fb594c93eb4f3196e8bdde5ded7eb32025-08-20T02:23:20ZengWileyCritical Care Research and Practice2090-13052090-13132020-01-01202010.1155/2020/14838271483827Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional StudyFernanda G. de M. Soares Pinheiro0Eduesley Santana Santos1Íkaro Daniel de C. Barreto2Carleara Weiss3Andreia C. Vaez4Jussiely C. Oliveira5Matheus S. Melo6Francilene A. Silva7Nursing Department, Federal University of Sergipe, Lagarto, Sergipe, BrazilGraduate Program in Nursing, Federal University of Sergipe, São Cristóvão, Sergipe, BrazilGraduate Program of Biometrics and Applied Statistics, Federal Rural University of Pernambuco, Recife, BrazilJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USANursing Department, Federal University of Sergipe, São Cristóvão, Sergipe, BrazilGraduate Program in Nursing, Federal University of Sergipe, São Cristóvão, Sergipe, BrazilGraduate Program in Nursing, Federal University of Sergipe, São Cristóvão, Sergipe, BrazilGraduate Program in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, BrazilBackground. 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.http://dx.doi.org/10.1155/2020/1483827
spellingShingle Fernanda G. de M. Soares Pinheiro
Eduesley Santana Santos
Íkaro Daniel de C. Barreto
Carleara Weiss
Andreia C. Vaez
Jussiely C. Oliveira
Matheus S. Melo
Francilene A. Silva
Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study
Critical Care Research and Practice
title Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study
title_full Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study
title_fullStr Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study
title_full_unstemmed Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study
title_short Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study
title_sort mortality predictors and associated factors in patients in the intensive care unit a cross sectional study
url http://dx.doi.org/10.1155/2020/1483827
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