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

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.

KEYWORDS:

• Hospital-acquired infection
• intensive care unit
• mortality rate
• Palestine
• sepsis

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (An-Najah University Hospital). Each participant provided informed consent before beginning the study.

Author contributions

Raghad Tambour: Conceptualization, Investigation, Methodology, Project administration, writing – original draft, Writing – review & editing. Malakeh Z. Malak: Methodology, Data curation, Validation, writing – original draft, Writing – review & editing. Hadi Rabee’: Methodology, Writing-original draft, Writing-review & editing. Zaher Nazzal: Methodology, Writing-original draft. Mohammad Gharbeyah: Methodology, Writing-original draft. Dina Abugaber: Methodology: Writing-original draft. Ibrahim Ghoul: Methodology: Writing-original draft.

Acknowledgments

The authors are very thankful to the ICU staff, including ICU specialists, ICU residents, and nurses, for providing help and support for the conduction of this study.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.