Determinants of Mortality in Respiratory Intensive Care Units

Objective: Respiratory intensive care units (RICUs) play a critical role in managing patients with severe respiratory conditions, including acute and chronic respiratory failure, severe lung infections, and pulmonary edema.Mortality-related factors in these specialized units may differ from those observed in general intensive care units.This study aims to identify these distinctions. Methods:We conducted a retrospective analysis of 406 patients admitted to a tertiary-level RICU.Data collected included scoring metrics-such as the Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment, Glasgow Coma Scale (GCS), and Charlson comorbidity index-along with the hospital department from which cases were transferred, biochemical blood test results, and the types of respiratory support administered.These variables were assessed to identify factors associated with mortality.Results: Mortality occurred in 69.1% of cases (n=244), while 30.9% (n=109) survived.Independent risk factors for mortality included higher APACHE II scores, lower GCS scores, the need for endotracheal intubation, inotropic support, reduced albumin levels, low hemoglobin levels, and elevated D-dimer levels.Notably, exacerbations of chronic obstructive pulmonary disease were associated with increased mortality compared to other primary pulmonary conditions (p=0.001).Furthermore, patients transferred from the emergency department demonstrated lower mortality than those transferred from other departments (p=0.001).Conclusion: Mortality risk factors in RICUs share similarities with those in other intensive care units.However, RICUs also have unique risk determinants related to underlying respiratory disorders and specific biomarkers, such as D-dimer, underscoring the need for targeted management strategies in this patient population.