Intensivists: don't quit your day job...yet!

摘要

CitationLevy MM, Rapoport J, Lemeshow S, Chalfin DB, Phillips G, and Danis M: Association between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit. Ann Intern Med 2008 Jun 3, 148(11): 801-9 [1].BackgroundCritically ill patients admitted to intensive care units (ICUs) are thought to gain an added survival benefit from management by critical care physicians, but evidence of this benefit is scant.MethodsObjectiveTo examine the association between hospital mortality in critically ill patients and management by critical care physicians.DesignRetrospective analysis of a large, prospectively collected database of critically ill patients.Setting123 ICUs in 100 U.S. hospitals.Subjects101,832 critically ill adults.InterventionNone.OutcomesThrough use of a random-effects logistic regression, investigators compared hospital mortality between patients cared for entirely by critical care physicians and patients cared for entirely by non-critical care physicians. An expanded Simplified Acute Physiology Score was used to adjust for severity of illness, and a propensity score was used to adjust for differences in the probability of selective referral of patients to critical care physicians.