Factors Impacting the Likelihood of Death in Patients in Intensive Care Unit

Background and Purpose: Intensive care units are special treatment units with high-tech equipment developed for the treatment and follow up of life-threatening organ failure seen in the course of both chronic and acute illnesses. These units have the highest mortality rates among hospital sections. To evaluate the factors affecting mortality in patients treated in ICUs and to determine the measures needed to reduce mortality rates. Methods: This retrospective cohort study was performed using patient files, ICU records, infection control committee surveillance data and information processing data between 1 January - 31 December, 2013, at the Kanuni Education and Research Hospital. Results: Average length of hospitalization was 17.3 ± 20.6 days. Mean Charlson co-morbidity index was 3.1 ± 1.8, and mean APACHE II score 19.7 ± 3.0. Four hundred ninety-seven patients (61.4%) died. The mortality rate was 23.7 per 1000 patient days. APACHE II score, the presence of nosocomial infections, and cerebrovascular disease were identified as independent risk factors affecting mortality in multivariable analysis. Mortality rate predicted by APACHE II score was 45.6%. The standardized mortality rate was 1.35. Hospitalization exceeded 48 hours in 566 patients, and 309 nosocomial infections developed in 205 of these. The nosocomial infection rate was 25.4 per 1000 patient days. Conclusion: High APACHE II score, Charlson co-morbidity index and nosocomial infections are the most important factors affecting mortality. It is vitally important that infection should be prevented in to reduce mortality rates, and appropriate treatment should be initiated at once in the presence of infection. Therefore, in addition to the development of rapid diagnostic methods, training should be provided to increase hospital management and personnel awareness of the importance of the subject. Communication between units should be enhanced, and intensive care conditions and services should be improved.