Determinants of mortality of non-ventilated patients admitted to ICU at selective hospitals of Nepal: A Secondary data analysis
<ns3:p> >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, <ns3:italic>p</ns3:italic> < 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, <ns3:italic>p</ns3:italic> < 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. </ns3:p>
Authors
- Niroj Hirachan (ORCID: https://orcid.org/0000-0003-1709-4907)
- Tamanna Bajracharya
- Rupesh Gami
- Subekshya Luitel (ORCID: https://orcid.org/0009-0005-0423-8926)
- Hem Raj Paneru (ORCID: https://orcid.org/0000-0002-3487-5388)
- Sabin Koirala (ORCID: https://orcid.org/0000-0001-8741-8079)
- Anand Thakur
- Shital Adhikari (ORCID: https://orcid.org/0000-0001-7215-6299)
- Sushil Khanal (ORCID: https://orcid.org/0000-0002-8338-194X)
- Pradip Tiwari (ORCID: https://orcid.org/0000-0003-4020-9995)
- Lalit Kumar Rajbanshi (ORCID: https://orcid.org/0000-0001-7531-634X)
- Sushila Paudel (ORCID: https://orcid.org/0000-0002-4824-8625)
- Kishor Khanal
- P L Shrestha
- Raju Shrestha (ORCID: https://orcid.org/0000-0002-5124-983X)
- Rakshya Bastola (ORCID: https://orcid.org/0009-0008-8477-6389)
- Sanjay Lakhey
- Diptesh Aryal
- Shuba Kalyan Sthrestha
- Subhash Parsad Acharya (ORCID: https://orcid.org/0000-0003-1596-0496)
- Basanta Gauli
Institutions
- nLIGHT (United States) (US)
- Chitwan Medical College (NP)
- BirdLife International (KE)
- Biratnagar Eye Hospital (NP)
- Intensive Care Foundation (AU)
- Nepal Development Research Institute (NP)
- Grande International Hospital (NP)
- Tribhuvan University Teaching Hospital (NP)
- Nepal Family Development Foundation (NP)
- Civil Service Hospital (NP)
- Kathmandu University (NP)
Publication Details
- Journal
- Wellcome Open Research
- Published
- 2026-04-10
- DOI
- https://doi.org/10.12688/wellcomeopenres.24567.1
- Primary Topic
- Sepsis Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Wellcome Trust