Assessment of the Clinical Interpreter of Death in Life-Threatening Infective Cases Admitted in the Intensive Care Unit of a North-Eastern State of India

Abstract

The clinical factors affecting a patient's condition monitored over time could be useful not only to decide on an intervention that may increase the patients' possibilities of survival but also to predict the treatment outcome. Therefore, this study evaluates the clinical factors as predictors of mortality among severe sepsis patients admitted in the intensive care unit (ICU) of a tertiary care center. Method We did a prospective study on over 50 life-threatening infective cases with different causes admitted in the ICU. Clinical and biochemical parameters like temperature, heart rate, blood pressure, bicarbonate levels, blood lactate levels, and pH were monitored at admission, after 24 hours, and after 72 hours. The statistical analysis was done using Microsoft Excel (Microsoft Corporation, Redmond, WA) and the Statistical Package for the Social Studies (SPSS) version 22 (IBM Corp., Armonk, NY). We have obtained ethical clearance from the ethics committee (human) of Assam Medical College and Hospital, Dibrugarh. Before the collection of the data, we also took informed consent from the participants. Results The mean age of non-survivors was 44.35±11.64 years and that of survivors was 36.60±9.28 years, and the difference was statistically significant (p-value <0.003). An analysis of values of the various vital signs indicated substantial differences in the mean at different time intervals among survivors and non-survivors (p-value <0.05). Among non-survivors, mean temperature, pulse, and rate of respiration were observed to increase over time while blood pressure and oxygen saturation levels were significantly decreasing. Compared to survivors, the mean lactate levels of non-survivors at different time intervals were statistically significant (p-value <0.05). It is also observed that the pH of non-survivors was lower than survivors, and the mean pH value significantly different at different time intervals among the two groups (p-value <0.05). Conclusion The temperature, pulse, rate of respiration, blood pressure, and oxygen saturation levels are essential determinants of patient mortality in those suffering from a severe infection, besides serial lactate levels, bicarbonate levels, and pH levels.