The Effectiveness of Scoring Systems and Various Biochemical Parameters in Predicting Survival in a Respiratory Intensive Care Unit

Aim: The aim of the present study was to compare various clinical and biochemical parameters, Acute Physiological and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) for their effectiveness in distinguishing surviving and non-surviving patients who had acute respiratory failure (ARF) while in the Respiratory Intensive Care Unit (RICU). Materials and Methods: A prospective observational clinical study was carried out in the RICU of the Chest Disease Clinic. One hundred and sixteen patients were observed. Laboratory parameters and scoring points for the first 24 hours were recorded. Patients' demographic characteristics, biochemical parameters, length of stay at the RICU, and GCS, APACHE II and SOFA scores were also recorded. The primary outcome of the current study was the mortality rate in the RICU. Results: Mortality rate was determined to be 39.6% (46 patients) of 116 patients, although the predicted mortality rate was 49.7 %. There was a statistically significant difference between surviving and non-surviving patients in terms of SOFA (p=0.004, OR=1.33, CI=1.10-1.61), INR (p = 0.02, OR = 3.95, CI = 1.30-12.07), albumin (p=0.02, OR=2.58, CI=1.17-5.64), and PCO2 levels (p=0.005, OR=1.04, CI=1.01-1.06), respectively. Conclusion: Our results suggest that the mortality rate may be higher when SOFA, INR, albumin and PCO2 abnormalities are seen. Co-morbidities such as non-pulmonary organ dysfunction and metabolic disorders other than respiratory failure may have contributed additionally to increased mortality risk for patients who were admitted to the RICU. These parameters should be taken into account when ARF patients are admitted to the RICU.