Positive fluid balance predicts mortality in intensive care unit patients
Background Positive fluid balance is known to be a factor to cause poor outcome in critically ill patients especially in patient with acute kidney injury. The goal of this study is to assess the outcome of positive fluid balance in general patients admitted to intensive care unit, Hospital Sulta...
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| Format: | Thesis |
| Language: | English |
| Published: |
2014
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| Subjects: | |
| Online Access: | http://eprints.usm.my/39669/1/Dr._Siti_Azila_Sulong__%28Anaesthesiology%29-24_pages.pdf http://eprints.usm.my/39669/ |
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| Summary: | Background
Positive fluid balance is known to be a factor to cause poor outcome in critically ill
patients especially in patient with acute kidney injury. The goal of this study is to assess
the outcome of positive fluid balance in general patients admitted to intensive care unit,
Hospital Sultanah Nur Zahirah.
Objectives
The main objective is to determine the association of positive fluid balance in causing
mortality of the critically patients who were managed in ICU.
Methodology
This is a retrospective cohort study. The patients who fulfilled the inclusion criteria and
were admitted to ICU between April 1st, 2012 and December 31st, 2013 were included
in this study. Data were abstracted from the medical record. Univariate analysis and
multivariate analysis were carried out to determine the association and the risk ratio of
PFB in predicting the death in ICU patients. ROC curve was plotted to assess the
optimal cut-off point.
Results:
A total of 200 patients were recruited for this study from which 40 patients were died
and 160 patients were alive during discharge from ICU. More than 90% of the patients
were Malays. The mean (SD) age group was 53.4 (18.1) years old. The main reasons for
ICU admission were respiratory failure (46%) and septic shock with respiratory failure 51%). Univariate analysis and multivariate analysis showed that those with positive
fluid balance of > 1L per day had 4-fold risk of dying as compared to those with
average fluid balance of <1L per day (RR=4.0, 95% CI 2.20, 7.36, P <0.01). The ROC
curve showed the cut off point for average fluid balance that risk to mortality was 987
ml per day.
Conclusion:
The average positive fluid balance of >1L per day during ICU stay is a risk factor for
mortality among the critically ill patients managed in ICU.
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