Organ Support Requirements as Markers of Disease Severity and Mortality in Hospitalized Patients

TL;DR

This study shows that the need for organ support in hospitalized patients is a strong indicator of disease severity and higher mortality.

Contribution

The study introduces organ support requirements as practical, retrospective markers of disease severity and mortality risk.

Findings

Patients requiring organ support had significantly higher mortality rates compared to those without.

Mortality increased with the number of organ supports required, showing a dose–response relationship.

Organ support variables should be interpreted as prognostic indicators rather than independent severity measures.

Abstract

Background: Assessing disease severity in hospitalized patients is essential for risk stratification and clinical decision-making. While formal severity scores are not always available in routine practice, organ support requirements may serve as pragmatic markers of critical illness. This study evaluated organ support modalities as indicators of disease severity and their association with in-hospital mortality. Methods: This retrospective observational study included 1332 adult hospitalized patients managed in either the intensive care unit or medical wards. Data on demographics, clinical complications, organ support requirements (mechanical ventilation, inotropic support, and hemodialysis), and outcomes were extracted from medical records. Cumulative organ support burden was categorized as none, single-organ, or multi-organ support. In-hospital mortality was the primary outcome. Results: Mechanical ventilation was required in approximately 71% of patients, inotropic support was required in 31%, and hemodialysis was required in 8%. Mortality was markedly higher among patients requiring organ support compared to those who did not. Mortality reached 70.4% in ventilated patients, 85.1% in those receiving inotropes, and 84.8% in those undergoing hemodialysis. A clear dose–response relationship was observed, with mortality increasing from 3.9% in patients requiring no support to 54.9% in those requiring one modality and 87.6% in those requiring multiple supports. Conclusions: Organ support requirements were strongly associated with in-hospital mortality and may serve as pragmatic prognostic indicators in retrospective datasets where formal severity scores are unavailable. However, given that organ support is initiated in response to clinical deterioration, these variables should be interpreted primarily as markers of prognostic association rather than independent severity measures.

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