Abstract: Objective To analyze the distribution profiles and influencing factors of common laboratory critical values in the intensive care units （ICUs） of Class A tertiary hospitals, providing a reference for clinicians to formulate corresponding diagnosis and treatment strategies. Methods A retrospective survey was conducted to collect laboratory critical value reports from the ICUs of a Class A tertiary hospital in Shanghai from January 2023 to December 2023, and analyze patient gender, age, surgical conditions, departments of the ICUs, and critical value items. Using the Pareto principle, the items that accounted for the top 80% of laboratory critical values were considered common laboratory critical values, and were analyzed by department, gender, perioperative/non-perioperative, and age group to determine the influencing factors of these 80% critical values, with a focus on the 20% of influencing factors. Results A total of 1075 cases with laboratory critical value data were collected from 5 ICUs, and the items that accounted for the top 80% of laboratory critical values included elevated troponin, elevated urea nitrogen, hypokalemia, elevated creatinine, leukocytosis, and thrombocytopenia, which were mainly distributed in patients from the department of orthopedics, general surgery, urology, and neurosurgery during perioperative period. The most common items in perioperative period were elevated troponin in 267 cases （27.81%）, hypokalemia in 120 cases （12.50%）, and elevated creatinine in 105 cases （10.94%）. According to age group, there were 189 cases of critical values in middle-aged people （45-59 years）, accounting for 17.58%; 443 cases occurred in young elderly people （60-74 years）, accounting for 41.21%; 278 cases in elderly patients （75-89 years）, accounting for 25.86%. Conclusion The ICUs should pay attention to common laboratory critical values such as elevated troponin, elevated urea nitrogen, hypokalemia, elevated creatinine, leukocytosis, and thrombocytopenia, and take timely and predictable diagnostic and treatment measures to improve the success rate of rescue and patient survival.

Key words: Intensive care unit, Critical values, Pareto principle, Diagnosis and treatment measures