Journal of Medical and Surgical Intensive Care Medicine 2010 , Vol 1, Issue 1
Prognosis of Patients in a Medical Intensive Care Unit of a Tertiary Care Centre
Nevin Uysal 1 , Nevhiz Gündoğdu 1 , Şermin Börekçi 1 , Öner Dikensoy 1 , Ayten Filiz 1 , Erhan Ekinci 1 , Hasan Bayram 1 , Meral Uyar 1 , Nazan Bayram 1 , Gökhan M. Mutlu 2
1Gaziantep Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Gaziantep, Türkiye
2Northwestern Üniversitesi, İç Hastalıkları Anabilim Dalı, Göğüs Hastalıkları ve Yoğun Bakım Bilim Dalı, Feinberg Tıp Fakültesi, Chicago, IL, USA

This study was undertaken in the Gaziantep University Medical Intensive Care Unit (ICU) and  aimed at determining the characteristics of patients, rates of invasive procedures, ICU length of stay, ICU mortality and its predictors. Between February 2007 and October 2008, 1033 patients were admitted to the ICU. Mean age was  55.3±19.2, mean APACHE II score was 19.5±9.6. The most common indications for ICU admission were hemodynamic instability (44%), mental status change (31%) and respiratory failure (30%). Sepsis (8%), pneumonia (6.7%), COPD exacerbation (5.8%), cerebrovascular accident (5.2%), gastrointestinal bleeding (4.5%), acute renal failure (3.5%) and meningitis (3.2%) were the most common ICU admitting diagnoses. Emergency rooms or regular wards were the most common sources of admission (>90%), only 8% of the patients being transferred from another center. Arterial catheterization was the most commonly performed invasive  procedure (75%),  followed by invasive mechanical ventilation (52%) and central venous catheterization (52%). Noninvasive mechanical ventilation was used in 12% of the patients. Median ICU length of stay was 4.3 (IQR 2.0-9.0) days. ICU mortality was 43%. Standardized ICU mortality (observed mortality / expected mortality based on APACHE II score) was 1.24 (CI, 1.11-1.38). APACHE II score >20,  age >40, need for central venous catheterization and invasive mechanical ventilation for >24 hours increased ICU mortality, whereas a history of COPD decreased ICU mortality. 

Keywords : Intensive care, ICU length of stay, ICU mortality, APACHE II score