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[참여대학원생 고우리] 외과계 중환자실 환자의 환자분류체계와 APACHE Ⅱ 점수의 관련성과 사망 예측력 비교
고우리, 조성현, Go UR, Cho SH. 외과계 중환자실 환자의 환자분류체계와 APACHE II 점수의 관련성과 사망 예측력 비교. J Korean Acad Nurs Adm. 2024 Jan;30(1):67-78.https://doi.org/10.11111/jkana.2024.30.1.67
To explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.
Keywords
Abstract
PurposeTo explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.
Keywords
Intensive care unit; Patient classification system; Nursing care needs; Acuity; Mortality
중환자실; 환자분류체계; 간호필요도; 중증도; 사망