ICU Patients' Survival and Nursing Critical Patient Severity Classification System (CPSCS)

Purpose: To explore the relationship between ICU survival rate and patient severity classified using CPSCS recorded by nurses.

Method: The study design was retrospective research. We included patients who were admitted to 2 medical and 2 surgical ICUs at a university hospital in Seoul, Korea in 2012. The data of patient information and nursing records were retrieved. CPSCS was recorded daily based on 10 nursing intervention criteria, and classified patients from grade 1 to 6. After patients who were re-admitted to ICU and spent less than 24 hours in ICU were excluded, 1267 patients were included in analysis. Survival analysis was conducted by Kaplan-Meier test, Log-rank test, and Cox proportional hazard regression using STATA 13.0.

Results: Eighty five percent of patients were CPSCS grade 5 out of 6 highest severity. ICU survival rate was 47.5% on 1^st month. There was a significant difference of survival rate between the units (Medical vs Surgical ICUs), severity grade, and pneumonia Dx. In the Cox hazard regression model, ‘treatment (more than 30min)’, ‘treatment (less than 30min)’ and ‘vital sign’ were statistically significant as the risk factors of ICU patients’ mortality.

Conclusion: The CPSCS was a statistically significant predictor of ICU mortality depending on ICU length of stay. Existing nursing records in EMR should be further studied to emphasize nursing contribution to patient outcomes.