Factors associated with mortality in the Medical Intensive Care Unit at Chiangrai Prachanukroh Hospital
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Abstract
BACKGROUND: Critically ill patients require close monitoring in the Intensive Care Unit (ICU) and often present with complex medical conditions, along with high mortality rates. The management of these patients requires substantial medical resources. Therefore, understanding the factors associated with mortality in the ICU is important, as it enables the multidisciplinary team to improve care approaches and allocate medical resources more efficiently.
OBJECTIVE: To identify factors associated with mortality among patients admitted to the Medical Intensive Care Unit (MICU) at Chiangrai Prachanukroh Hospital.
METHODS: This retrospective cohort study included 120 adult patients aged 18 years and older who were admitted to the MICU at Chiangrai Prachanukroh Hospital for more than 24 hours between March 1 and August 31, 2025. Data were collected from electronic medical records, including demographics characteristics, comorbidities, severity scores (SOFA score), and laboratory results. Data were analyzed using descriptive statistics and Poisson regression analysis to identify factors associated with mortality.
RESULTS: The ICU mortality rate was 23.3% (n=28). Univariable analysis showed that non-survivors had significantly higher SOFA scores, lower S/F ratios, longer duration of mechanical ventilation, and higher rates of nosocomial infection and hospital-acquired pneumonia. In addition, the use of vasopressor, sedatives, and muscle relaxants was significantly more frequent in the non-survivor group (p<0.05). Multivariable analysis identified two independent predictors of mortality: a lower S/F ratio (aRR 0.99; 95% CI 0.99–1.00; p=0.029) and the use of muscle relaxants (aRR 1.84; 95% CI 1.01–3.35; p=0.045).
CONCLUSIONS AND RECOMMENDATIONS: A lower S/F ratio and the administration of muscle relaxants were significant independent predictors of ICU mortality. The use of the S/F ratio for clinical monitoring and patient follow-up, together with a more judicious and targeted approach to muscle relaxant administration, may help improve patient survival in the ICU.
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