The following is a summary of “Association Between Nurse Copatient Illness Severity and Mortality in the ICU,” published in the February 2024 issue of Critical Care by Riman et al.

Researchers conducted a retrospective study to investigate whether the illness severity of fellow ICU copatient influences individual patient mortality rates.

They utilized electronic health records from a multi-hospital health system (2018 to 2020). Nurse-to-patient assignments were pinpointed for every 12-hour shift through a validated algorithm. The severity of the patient’s illness was determined based on whether the index patient’s copatient received mechanical ventilation or vasoactive support during the shift. Proportional hazard regression with time-varying covariates was employed to analyze the connection between copatient illness severity and 28-day ICU mortality.

The results showed 20,650 patients and 84,544 patient shifts. Regression analyses revealed that a patient’s risk of death increased when their copatient received both mechanical ventilation and vasoactive support (HR: 1.30; 95% CI, 1.05–1.61; P=0.02) or vasoactive support alone (HR: 1.82; 95% CI, 1.39–2.38; P<0.001), compared with situations in which the copatient received neither treatment. However, if the copatient was solely on mechanical ventilation, there was no significant increase in the risk of death (HR: 1.03; 95% CI, 0.86–1.23; P=0.78). Sensitivity analyses performed on cohorts with different numbers of copatients consistently demonstrated an increased risk of death when a copatient received vasoactive support.

Investigators concluded that copatient illness alongside individual patient factors could inform nurse-to-patient assignments, potentially improving ICU survival rates.

Source: journals.lww.com/ccmjournal/fulltext/2024/02000/association_between_nurse_copatient_illness.3.aspx