DOI: 10.36347/sjams.2023.v11i05.002

Pages: 820-827

Despite major advances that were made in intensive care unit, mortality rate remains high. The objective of our study was to analyze the incidence and predictive factors of mortality in a surgical intensive care unit, in order to apprehend these factors for an optimal management. We have conducted a retrospective study about 100 consecutive cases of patients admitted to the surgical intensive care unit of Ibn Sina University Hospital in Rabat, during a 3-month period (02/01/2021-02/04/2021). Nearly 20 parameters were collected, analyzed and compared between the group of survivors and the group of deceased. The results shows that the mean age of the patients was 56.86 years, and the sex ratio of men to women was 1,56. Medical comorbidities were dominated by hypertensive and/or ischemic heart disease (38%), diabetes (22%), smoking (27%), neoplasia (17%). 61% of patients were admitted for a surgical pathology, 30% for a medical pathology, and 9% for a traumatic reason. The average APACHE II score at admission was 14,61. On the therapeutic level: 39% of the patients had recourse to vasoactive drugs, 49% had recourse to mechanical ventilation, 6% benefited from extra-renal purification, and 46% from a transfusion of blood derivatives. The average length of stay was 6,46 days. Multivariate analysis using binary logistic regression identified the following factors as independent mortality factors: the existence of neoplastic comorbidities, admission for a medical reason, the elevated APACHE II score, the need for vasoactive drugs, the prolonged mechanic ventilation, the need for transfusion, and the elevated length of stay, all of them were significant. Knowing the predictive factors of mortality will allow us to improve the quality of the care provided, and to target an eventual preventive action to improve the prognosis and to decrease mortality in intensive care unit.