Predictors of Mortality in Surgical Patients Admitted to a Tertiary Intensive Care Unit

Résumé fourni par la source

Background: Intensive Care Units (ICUs) provide critical support for patients after major surgery or acute abdominal conditions. Despite medical advances, mortality remains high in surgical ICU patients. This study aimed to identify clinical and biochemical predictors of mortality in surgical patients admitted to a tertiary ICU. Methods: We conducted a retrospective case-control study on 231 adult general surgery patients admitted to a tertiary anesthesia ICU between January 2018 and December 2023. Patients under 18 or who underwent solid organ transplantation were excluded. Data collected included demographic, clinical, and laboratory parameters such as Glasgow Coma Scale (GCS), APACHE II, SOFA, HALP scores, neutrophil/lymphocyte ratio (NLR), CRP/albumin ratio, and others. Patients were divided into mortality and survival groups, with subgroup analyses for malignancy, sepsis, and trauma. ROC and Cox regression analyses identified mortality predictors. Results: The ICU mortality rate was 64.9%. Significant predictors included age ≥58 (OR 4.56), BMI >30 (OR 7.62), mean arterial pressure <70 mmHg (OR 1.66), serum albumin <21.3 g/L (OR 1.5), APACHE II >18.5 (OR 2.42), and SOFA >9.5 (OR 2.68). Mortality was significantly associated with lower GCS, prolonged ventilation, inotropic support, and notably, a significantly elevated CRP/albumin ratio in the mortality group (p=0.024). Other inflammatory markers showed no significant difference. Predictive factors varied among subgroups. Conclusion: Older age, obesity, hypotension, hypoalbuminemia, and high severity scores independently predict mortality in surgical ICU patients. Early risk identification may enhance management and improve outcomes in this population.

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