Work

Determinants of mortality of non-ventilated patients admitted to ICU at selective hospitals of Nepal: A Secondary data analysis

Year: 2026

Type: article

Abstract: >Background The Intensive Care Unit (ICU) is vital for critical care, yet mortality remains a pressing issue. While much critical care research focuses on mechanically ventilated patients, non-ventilated critically ill patients also face substantial mortality risks. This study aimed to identify key determinants of mortality among non-ventilated ICU patients in selected Nepalese hospitals. Methods A retrospective observational design was employed, utilizing secondary data from the Nepal Intensive Care Research Foundation (NICRF). The dataset included records from 13,093 non-ventilated ICU patients across 14 hospitals in Nepal, collected between 2019 and 2022. Statistical analysis involved the Mann-Whitney U test for continuous variables, Pearson's chi-squared test for categorical variables, and binary logistic regression analysis to identify predictors of mortality. Results The overall ICU mortality rate was 11.1% (1,455 deaths). Deceased patients were significantly older than survivors (mean age 61.45 vs. 54.38 years, p < 0.001). Multivariable regression identified several independent predictors of mortality: antibiotic use (OR = 2.17), cardiovascular support (OR = 3.04), vasoactive therapy (OR = 2.99), ICU readmission (OR = 1.74), and unplanned admission (OR = 0.30 for planned, p < 0.05). Admission from the operating theater was associated with the highest mortality risk (OR = 8.81), while admission from ICU/HDU or wards had lower odds compared to emergency admissions. Severe respiratory comorbidity, hypertension, type 2 diabetes, chronic kidney disease requiring dialysis, and moderate to severe hepatic disease were also significantly associated with mortality. Conclusion Mortality among non-ventilated ICU patients in Nepal is influenced by both clinical severity and admission characteristics. These findings highlight the importance of proactive monitoring of high-risk patients, improved discharge planning, and strengthened perioperative care to enhance survival outcomes in critical care settings.

Source: Wellcome Open Research

DOI: 10.12688/wellcomeopenres.24567.1