Predic tors o f i n-hospital m or tality in patients requiring tr an sfer to the me dical in tensive care unit.

Objective: To identify the factors associated with higher odds of in-hospital mortalit y among inpatients requiring transfer to the medical intensive care unit.

Methods: The ret rospective audit was conducted from Ap r il 1 to September 30, 2023, at The Aga Khan University Hospital, Karachi, Pak is t an and com prised dat a from January 1 , 2018, to December 31, 20 22, of patients initially admitted to the general ward or high dependency unit in the Department of Medicine who required transfer to the medical intensive care unit during hospitalisation. Data was analysed using SPSS 23.

Results: Of the 601 patients with mean age 53.6±17.4 years, 373(62.1%) were males. Overall, 321(53.6%) of the patients expired while in the hospital. Patient s w hose t r ansfer t o the intensive care un it wa s initi ate d withi n 48 hours of admission had l o wer in-hospital mortality co mpared to those whose transfer wa s initiated beyond 48 hours of admission (p=0.004). Patients with a his to r y of autoimmune disease or mali gnancy as co -morbid conditions, o r a primary discharge diagnosis of sepsis had higher odds of in-hospital mor tality (p<0.05).

Conclusion: In-hospital mortality in patients requiring transfer to the intensive care unit was found to be very high. Early transfer to intensive care unit could lead to improved survival rate.