PROGNOSIS OF PATIENTS WITH ACUTE RESPIRATORY FAILURE AND PROLONGED INTENSIVE CARE UNIT STAY AT A TERTIARY CARE HOSPITAL: A RETROSPECTIVE STUDY
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Date
2025-03-16
Authors
Mallouh, Manar
Journal Title
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Publisher
An-Najah National University
Abstract
Background: Acute respiratory failure (ARF) is one of the greatest serious clinical
conditions often need ICU admission and is linked with prolonged hospital stay. The
main purpose of this study was to examine outcomes in order to identify risk factors
related to the length of stay (LOS) in the intensive care unit (ICU) of patients with ARF.
Methods: In this retrospective cohort study, patients were admitted from 2018 to 2023 to
the intensive care unit of a tertiary care hospital and were involved if they were adults
diagnosed with ARF volunteer. We systematically retrieved demographic characteristics
within electronic health records and documented clinical variables and interventions of
every patient, including ventilation support. Logistic regression models, t-tests, and chisquare tests were completed using the Statistical Package for Social Sciences (SPSS)
version 21 to govern potential predictors of mortality and LOS.
Results: Out of the 460 participants, 61–52 percent were male, with an average age of 59.
However, neither age nor gender was found to significantly influence mortality rates. Vital
clinical signs of impending death comprise of a systolic blood pressure below 110 mmHg,
a heart rate of 100 bpm or higher, a temperature under 37°C, a Glasgow coma scale score
below 14, a hematocrit value of fewer than 26, a sodium concentration below 139 mEq/L,
and a pH value below 7.36. There appeared to be higher survival rates between patients
who had lower acute physiology and chronic health evaluation (APACHE) scores. On the
other hand, shorter periods on ventilators and less invasive procedures were connected with
better outcomes. Significant issues that affected mortality are such as admission for
pneumonia, acute respiratory distress syndrome, and post-operative cases while
complications like vasopressor use, renal disease, and hepatic injury also improved the
rates of death as well as longer LOS.
Conclusion: This study highlights the significance of thorough clinical assessment and
modified management strategies for ICU patients with ARF who have long stays. To
improve survival rates while reducing the period of hospital stays, standard risk assessment
tools such as the APACHE score should be used alongside progressions in ventilation
methods. Moreover, employing multidisciplinary approaches to tackle the patient's
comorbidities and associated complications can improve the prognosis even more.