Respiratory intensive care unit factors affecting mortality

Rate of mortality is high in patients admitted to Intensive Care Unit (ICU). Assessment of disease severity and recognition of mortality risk factors are of great importance in determining the patient's prognosis. Also, determination of management strategies and effect the use of resources. This study in determining the prognosis of patients admitted to ICU admission with scoring systems during hospitalization. Furthermore, weaim to exchange of values on the third day of the laboratory parameters examined. Eighty six patients (aged between 22 and 93) who were treated in Dicle University Hospital, Respiratory Intensive Care Clinic between November 2013 and April 2014 were included in the study. Patients were divided into two groups, namely the dead and the living. APACHE II, SOFA, SAPS II and GCS scores were calculatedin the first day of admission to the ICU. Demographic data of the patients, diagnosis, clinical and laboratory findings, length of stay in the ICU, length his stay in mechanical ventilation were recorded. WBC, CRP, biochemical parameters and hormone levels were studied from the ICU to the time of entry and at the end of 72 hours in all patients. Results were compared between the dead and the living. The age of patients, gender and in length of stay in intensive care showed no significant difference between dead patients and living patients. Length of mechanical ventilation were significantly higher than those living to dead patients(p <0.05). Measured fewer, pulse and weight in dead group were statistically significantly different when compared to those living group (p<0.05). Systolic and diastolic blood pressure was found to be statistically significantly lower than those living to dead patients(p<0.05). In addition there was a statistically significantly difference compared to patients who were discharged in dying need of inotropic support (p <0.05). Patient's respiratory support during hospitalization observed no statistically significantly differences for mortality among groups. APACHE II, SOFA and SAPS II score were statistically higher significantly than the living patients to those dead patients. GCS was statistically lower significantly than the living patients to those dead patients. (p <0.001). During hospitalization studied for WBC, hemoglobin, hematocrit and CRP levels statistically was observed significantly increase according to the time of discharge in dead patients. Lower platelet count statistically was observed significant according to the living in dead patients (p <0.05). Lower albumin, urea, creatinine and higher HDL, LDL cholesterol, direct bilirubin, and CK levels examined from biochemical parameters among patients admitted to the intensive care unit, was statistically significant compared to than those living in the dead (p <0.05). Sodium, potassium, glucose, AST, ALT values were no significant differences between the groups in terms of mortality. Looking at the hormone levels during hospitalization; lower T4 and higher cortisol, ACTH, GH were statistically significant differences than those living in the dead (p <0.05). However, T3, and TSH, DEAH detected no significant differed between the groups for mortality. In addition in our study, we aim to exchange of values on the third day of the laboratory parameters examined. Lower phosphorus levels were found significant differences among the dead and the living patients (p <0.05). Looking at the other parameters, no significant differences between the groups for mortality. Finally, scoring systems may be an indicator for mortality, Laboratory parameters examined in lower platelet count, albumin, üre creatinin and higher cortisol, ACTH, BH, cholesterol, direct bilirubin levels that admitted during hospitalization in critically ill patients may be indicative of mortality. However, lower phosphorus levels when in the change of the third day investigated laboratory parameters were statistically found to be significantly. Keywords: İntensive Care Unit, Mortality, Scoring Systems, Laboratory Parameters, Chest Disease