J Korean Acad Nurs Adm.  2024 Jan;30(1):67-78. 10.11111/jkana.2024.30.1.67.

Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit

• Go UR
• Cho SH

• KMID: 2562919
• DOI: http://doi.org/10.11111/jkana.2024.30.1.67

Abstract

Purpose
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.

Keyword

Intensive care unit; Patient classification system; Nursing care needs; Acuity; Mortality