The Investigation of Possible Associated Risk Factors and Causes of Mortality in Intubated Patients in ICU during Five Days of Admission

Abstract

Background and aims: A hospital's intensive care unit (ICU) is a location where seriously ill and high-risk patients can get vigorous therapy while being monitored with both invasive and noninvasive techniques. A typical treatment in the ICU, endotracheal intubation, is linked to a high frequency of problems because critically sick patients' unstable hemodynamic and respiratory conditions. Between 25 to 39% of ICU patients experience life-threatening side effects from endotracheal intubation, including severe hypoxia, cardiovascular collapse, cardiac arrest, and death. This study aimed to investigate the causes of mortality of intubated patients admitted to the ICU, the presence of comorbidities, and their effect on mortality in Iraq/Karbala.

Method: This cross-sectional study was conducted in 70 ICU’s patients during 2022 in Karbala city. We selected the hospitals and based on the sample size in each hospital. In 2022, the variables were gathered using a researcher-made checklist as part of a random sampling. Medical care allowed for the collection of all the variables. For statistical analysis, SPSS software (version 25) was used. The chi-square/exact method test was employed to ascertain whether the results for each group differed. We utilized odds ratios (OR) with a 95% confidence interval as a measure of the connection between the factors and the outcome in multi-variable adjusted logistic regression models. Every analysis was two-tailed, with a P-value of 0.05 or less considered statistically significant.

Result: Our multi-logistic regre-ssion showed that the odds of mortality in participants who admitted to the ICU adjusted with the odds of Mean Arterial Pressure group (more than 100) in the participants whom at first of admission 6.089 times (95%CI: 1.565, 23.686, p=0.009) and the odds of (more than 100) in the participants whom at fifth day of survival or death day of non-survival outcome of admission 73.121 times (95%CI: 5.749, 929.942, p=0.001)  So, the relationship was significant with elevation of mortality rate. In addition of that the hepatic conditions of participants were statically significant association with odds of mortality in outcome group (95%CI: 0.04, 0.19, P=0.003) in spite of that we didn’t used logistic regression for this variable because there are 0 % survivor when a patient affected with hepatic conditions. So, the outcome of non-survivor is exclusive. Also, Acid Base Balance disturbance of participants was significant relationship with odds of mortality in outcome group at fifth day of survival or death day of non-survival outcome of admission (95%CI: 1.66, 2.37, P=0.006). We didn’t discuss it because Pvalue in logistic regression was <0.05.

Conclusion: In critically ill patient’s mortality ratio was high in our study. we identified in univariate and multi logistic regression statistically significant association between MAP and in-ICUs, 5-day mortality. Hepatic condition, Acid base balance and vasopressor groups in univariate was statically significant association with mortality in outcome group. In future the studies of ICU mortality should put these variables in consideration.