Comparing Outcomes of Critically Ill Patients in Intensive Care Units and General Wards: A Comprehensive Analysis

Figures & data

Table 1 Baseline Characteristic

	Intensive Care Units (n=72)	General Wards (n=108)	P
Female, n (%)	29 (40.3)	55 (50.9)	0.16
Age, mean ± SD, years	58.3 ± 18.7	68.7 ± 15.8	< 0.001*
BMI, mean ± SD	24.2 ± 6.1	22.3 ± 5.1	0.03*
Comorbidities, n (%)
Diabetes mellitus	28 (38.9)	37 (34.3)	0.53
Hypertension	38 (52.8)	72 (66.7)	0.06
ESRD on RRT	11 (15.3)	11 (10.2)	0.32
Cirrhosis	8 (11.1)	9 (8.3)	0.63
HIV infection	3 (4.2)	6 (5.6)	0.68
Cardiovascular disease	17 (23.6)	21 (19.4)	0.5
Malignancy	14 (19.4)	20 (18.5)	0.88
Severity score upon the request, mean ± SD
APACHE II	17.9 ± 7.7	13.3 ± 5.6	< 0.001*
SOFA score	5.8 ± 3.2	4.4 ± 3.0	0.003*
Diagnosis upon the request, n (%)
Sepsis	59 (81.9)	83 (76.9)	0.41
Hypotension	47 (65.3)	43 (39.8)	0.001*
Respiratory failure	54 (75.0)	74 (68.5)	0.35
Acute kidney injury	46 (63.9)	32 (29.6)	<0.001*
Alternation of consciousness	17 (23.6)	7 (6.5)	<0.001*
Acute coronary syndrome	4 (5.6)	2 (1.9)	0.18
Acute liver failure	12 (16.7)	1 (0.9)	<0.001*
Post-cardiac arrest	6 (8.3)	1 (0.9)	0.01*
Laboratory parameters, mean ± SD
Blood urea nitrogen (mg/dL)	39.7 ± 26.7	32.7 ± 26.5	0.09
Creatinine (mg/dL)	2.98 ± 2.81	1.96 ± 1.90	0.005*
P/F ratio	297.7 ± 151.4	257.1 ± 128.1	0.11
pH	7.32 ± 0.14	7.39 ± 0.10	0.004*
Lactate (mmol/L)	6.4 ± 6.3	4.0 ± 3.6	0.03*

Note: *Statistically significant.

Abbreviations: APACHE II, Acute Physiology and Chronic Health Evaluation II; BMI, body mass index; ESRD, end-stage renal disease; HIV, human immunodeficiency virus; P/F ratio, ratio of arterial oxygen partial pressure to fractional inspired oxygen; RRT, renal replacement therapy; SOFA, Sequential Organ Failure Assessment.

Table 2 Procedure and Organ Support During Admission

	Intensive Care Units (n=72)	General Wards (n=108)	P
Respiratory support, n (%)
Invasive mechanical ventilation	54 (75.0)	74 (68.5)	0.35
Noninvasive ventilation	1 (1.4)	6 (5.6)	0.18
High-flow nasal cannula	0 (0)	2 (1.9)	0.18
Hemodynamic monitoring and support, n (%)
IVC ultrasound	48 (66.7)	7 (6.5)	< 0.001*
Central venous catheter	62 (86.1)	11 (10.2)	< 0.001*
Arterial line	64 (88.9)	4 (3.7)	<0.001*
Pulmonary artery catheter	5 (6.9)	0	0.005*
Norepinephrine	47 (65.3)	43 (39.8)	0.001*
Norepinephrine dose, mean ± SD, mcg/kg/min	0.19 ± 0.21	0.12 ± 0.14	0.07
Other organ support, n (%)
Renal replacement therapy	29 (40.3)	8 (7.4)	<0.001*
Cardiopulmonary resuscitation	10 (13.9)	9 (8.3)	0.24

Note: *Statistically significant.

Abbreviation: IVC ultrasound, inferior vena cava ultrasound.

Table 3 Outcomes

Treatment Outcomes	Intensive Care Units (n=72)	General Wards (n=108)	P
Primary outcome
28-day mortality, n (%)	32 (44.4)	22 (20.4)	0.001*
Secondary outcomes
Hospital length of stay, mean ± SD, days	24.8 ± 22.8	23.3 ± 21.1	0.64
ICU length of stay, mean ± SD, days	9.7 ± 8.5	0	< 0.001*
Ventilator free days within 28 days, mean ± SD, days	15.4 ± 22.3	13.0 ± 19.3	0.48
Norepinephrine days, mean ± SD, days	4.7 ± 4.5	4.1 ± 3.5	0.46
Renal replacement therapy free day within 28 days, mean ± SD, days	22.7 ± 31.8	25.3 ± 21.0	0.89

Note: *Statistically significant.

Abbreviation: ICU, intensive care unit.

Table 4 Factors Associated with 28-Day Mortality

	Univariate Analysis			Multivariate Analysis
	Odds Ratio	(95% Confidence Interval)	P	Adjusted Odds Ratio	(95% Confidence Interval)	P
APACHE II ≥ 20	2.78	(1.35–5.73)	0.005*	0.53	(0.06–4.61)	0.57
SOFA score ≥ 5	2.4	(1.23–4.70)	0.009*	2.06	(0.26–16.51)	0.5
Hypotension	1.97	(1.03–3.78)	0.04*	0.05	(0.01–2.07)	0.12
Acute kidney injury	2.55	(1.33–4.92)	0.004*	0.29	(0.04–1.89)	0.29
Alternation of consciousness	5.58	(2.20–14.16)	< 0.001*	9.15	(1.11–75.16)	0.04*
Respiratory failure	2.25	(1.03–4.92)	0.04*	3.36	(0.16–71.41)	0.44
Bicarbonate ≤18 mmol/L	1.78	(0.93–3.41)	0.08	0.99	(0.13–7.40)	0.99
Lactate ≥4 mmol/L	2.78	(1.11–6.97)	0.03*	5.88	(0.85–40.84)	0.07
Respiratory rate ≥ 20/min	2.48	(1.14–5.38)	0.02*	4.2	(0.58–30.59)	0.16
Norepinephrine use	1.97	(1.03–3.78)	0.04*	57.81	(1.29–581.4)	0.04*
Epinephrine use	12.79	(3.47–47.13)	< 0.001*	15.78	(1.86 −133.65)	0.01*
ICU admission	3.17	(1.64–6.15)	< 0.001*	3.24	(0.41–25.76)	0.27

Note: *Statistically significant.

Abbreviations: APACHE II, Acute Physiology and Chronic Health Evaluation II; ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment.

Table 5 Factors Associated with Intensive Care Unit Acceptance (n=72)

	Univariate Analysis			Multivariate Analysis
	Odds Ratio	(95% Confidence Interval)	P	Adjusted Odds Ratio	(95% Confidence Interval)	P
Age ≤ 65 years	2.23	(1.12–4.11)	0.009*	1.24	(0.17–9.28)	0.83
BMI ≥ 23	2.69	(1.45–4.99)	0.002*	10.63	(1.32–85.86)	0.03*
APACHE II ≥ 20	2.96	(1.46–6.00)	0.002*	10.87	(1.24–95.10)	0.03*
SOFA score ≥ 5	2.99	(1.59–5.60)	0.001*	0.68	(0.07–6.17)	0.73
Alternation of consciousness	4.46	(1.74–11.41)	0.001*	0.47	(0.03–7.99)	0.6
Heart failure	0.56	(0.3–1.03)	0.06	0.37	(0.06–2.15)	0.27
Circulatory failure	21.4	(2.72–168.63)	<0.001*	5.16	(0.19–177.61)	0.32
Acute kidney injury	4.2	(2.23–7.92)	<0.001*	10.39	(1.30–82.88)	0.03*
Norepinephrine use	3.37	(1.42–7.98)	0.005*	0.15	(0.02–1.40)	0.09
Bicarbonate ≤ 18 mmol/L	3.35	(1.79–6.28)	<0.001*	0.95	(0.20–4.42)	0.95
Lactate ≥4 mmol/L	2.4	(1.03–5.68)	0.04*	0.75	(0.14–4.14)	0.74
pH ≤7.3	3.06	(1.31–7.16)	0.008*	6.58	(0.68–64.08)	0.11
PaCO2 ≤ 35	2.94	(1.37–6.29)	0.005*	2.83	(0.44–18.18)	0.27
Minute ventilation ≥ 10 L/min	1.83	(0.89–3.76)	0.09	3.33	(0.54–20.45)	0.19

Note: *Statistically significant.

Abbreviations: APACHE II, Acute Physiology and Chronic Health Evaluation II; BMI, body mass index; PaCO₂, arterial carbon dioxide partial pressure; SOFA, Sequential Organ Failure Assessment.