Sentiment Scores in Nursing Notes Associated with the Prognosis of Patients Undergoing Cholecystectomy

This study examined the relationship between sentiment scores and the prognosis of cholecystectomy patients with an intensive care unit (ICU) length of stay (LOS) ≥ 24 h. A total of 267 patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were included. Sentiment scores derived from nursing notes in the MIMIC-IV note module using TextBlob. The analyzed text was generated at hospital discharge. Accordingly, all findings are interpreted as descriptive associations. Receiver operating characteristic (ROC) curves, the DeLong test, and decision curve analysis (DCA) were used to descriptively characterize the discrimination of sentiment polarity and sentiment subjectivity for 3-, 7-, and 10-day ICU LOS, and to compare sentiment polarity with clinical indicators for 7-day ICU LOS. Restricted cubic spline (RCS) and generalized linear regression evaluated their associations with ICU LOS. Sentiment polarity achieved a higher area under the curve (AUC) than sentiment subjectivity; the DeLong test showed a significant difference for 3-day ICU LOS (p = 0.015), borderline for 7-day (p = 0.057), and non-significant for 10-day (p = 0.587). For 7-day ICU LOS, sentiment polarity showed a higher AUC with exploratory net benefit on DCA within specific threshold ranges. Sentiment polarity had a nonlinear correlation with 7-day ICU LOS (p overall = 0.002, p nonlinear = 0.027), whereas sentiment subjectivity did not. Generalized linear regression showed an association between sentiment polarity and ICU LOS that was independent of measured covariates (all p < 0.05 in crude and adjusted models). For secondary outcomes, sentiment polarity was associated with in-hospital mortality and 28-day hospital LOS in RCS analysis (all p < 0.05), with exploratory discriminative ability requiring further validation. In conclusion, among these patients, sentiment polarity was descriptively associated with ICU LOS, in-hospital mortality, and 28-day hospital LOS; these findings should not be generalized to all cholecystectomy patients.