Abstract
Predicting mortality in intensive care unit (ICU) patients is crucial for optimizing treatment strategies. This study aimed to evaluate the prognostic value of comorbidities, CRP/albumin ratio and lactate levels in predicting mortality, providing comprehensive insights into these parameters. This retrospective study was conducted between 2016 and 2021 in the ICU at a university hospital. Demographic data, comorbidities, and ICU length of stay were recorded, while APACHE II scores and laboratory parameters were measured within the first 24 hours following ICU admission. The study compared survivors and non-survivors using a 1:1 matching methodology. The association of these variables with mortality was statistically analyzed. The study included 540 patients, with a mean age of 64.1 ± 16.6 years and 62.4% were male. The mortality rate was 50%, and non-survivors were slightly older than survivors (65.3 ± 12.5 vs 63.1 ± 13.5 years, P = .12). Hypertension (43.3% vs 24.1%, P < .001), coronary artery disease (16.7% vs 6.7%, P < .001), and chronic renal failure (13% vs 3%, P < .001) were significantly higher in non-survivors. Increased mortality was significantly associated with higher lactate levels (5.78 ± 2.98 vs 3.11 ± 2.11 mmol/L, P < .001), higher CRP/albumin ratios (36.45 ± 26.42 vs 18.15 ± 14.57, P < .001), and lower albumin levels (3.21 ± 0.56 vs 3.61 ± 0.55 g/dL, P < .001). Additionally, univariate logistic regression analysis showed that each unit increase in WBC (OR: 1.03, 95% CI: 1.01-1.05, P < .001), NEU (OR: 1.08, 95% CI: 1.05-1.11, P < .001), PLT (OR: 1.02, 95% CI: 1.01-1.03, P < .001), and lactate (OR: 1.51, 95% CI: 1.38-1.62, P < .001) was associated with an increased risk of mortality. This study highlights that CRP/albumin ratio, lactate levels and comorbidities are significantly associated with increased mortality in ICU patients. Moreover, unit increases in WBC, NEU, and PLT were also linked to a higher mortality risk. These findings can improve clinical management through the early identification of high-risk patients in ICUs.