Variables Influencing Mortality in Asthmatic Patients Admitted to the Intensive Care Unit with Respiratory Failure

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Introduction: Acute respiratory failure caused by asthma episodes has decreased significantly due to the use of anti-inflammatory and bronchodilator inhalers. Although asthmatic individuals require less intensive care units, respiratory failure can still cause intensive care unit mortality. Our study examined characteristics that define the mortality risk in asthmatic patients with respiratory failure in the intensive care unit. Methods: A teaching diseases hospital's intensive care units were the setting for the retrospective, observational, cross-sectional study from 2016 to 2021. Asthmatic patients in the intensive care unit with acute respiratory failure were included in the study. Causes of respiratory failure, intensive care severity score (APACHE II), type of respiratory supports (invasive and noninvasive mechanical ventilation, high flow oxygen therapy) and duration, length of intensive care unit stays, and mortality rates were recorded. A multivariate regression analysis model for mortality risk was used and analyzed by classifying mortality risk factors. Results: The study, ICUs examined 14,575 patients. Asthma affected 438 people (3%). The study included 438 patients, 347 of whom were female (79%). Median (25%-75%), age and APACHE II score were 68 (55-78) and 17 (14-22). In asthmatics, pneumonia caused 50.5% of acute respiratory failure, sepsis 27.4%, Covid-19 14.4%, acute renal failure 8%, and acute cardiogenic edema 6.6%. The invasive mechanical ventilation was 21% (n=94), the mortality was 48 (11%). The odds ratios (confidence interval 95%, lower-upper limit) for mortality were congestive heart failure (CHF): 4.47 (1.55-12.85), APACHE II score of 20 or higher: 2.65 (1.10-6.38), invasive mechanical ventilation: 26.33 (9.80-70.70), and COVID-19: 2.84 (1.20-6.75). Conclusions. Asthmatics requires nearly 3% ICU treatment for respiratory failure for various reasons. In asthma patients, an intensive care unit need due to APACHE II value above 20, invasive mechanical ventilation, COVID-19 and congestive heart failure increase the risk of mortality in the ICU.

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