Eyad Kawar1, Bruno DiGiovine. 1. Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Abstract
BACKGROUND: Data on the perfomance of physician assistants in a medical intensive care unit are scarce. OBJECTIVE: To compare clinical outcomes between patients admitted to a resident-run MICU and a PA-run MICU. METHODS: Retrospective analysis of prospectively collected MICU data was performed for 5,346 patients admitted to an MICU from January 2004 through January 2007; 3,971 patients were admitted to a resident-run MICU (resident group) and 1,375 to a PA-run MICU (PA group). RESULTS: The groups were relatively similar, though the resident group had a higher rate of renal insufficiency (25% vs. 22%, P = .05) and the PA group had a higher rate of cerebrovascular accidents (5.6% vs. 4%, P = .02). Hospital length of stay (LOS) was similar, with a median of 9 days in the PA group and 8 days in the resident group (P = .59). MICU LOS was slightly longer for the PA group: a median of 2.58 days (1.55-4.86) vs. 2.33 days (1.39-4.16) in the resident group. After matching by propensity score, we could not confirm this increased LOS. There was no difference in hospital mortality or in ICU mortality between the two groups either in uncontrolled or controlled analyses. Survival analyses showed no difference in 28-day survival between the two groups. CONCLUSION: A PA-run MICU has similar outcomes when compared to a resident-run MICU.
BACKGROUND: Data on the perfomance of physician assistants in a medical intensive care unit are scarce. OBJECTIVE: To compare clinical outcomes between patients admitted to a resident-run MICU and a PA-run MICU. METHODS: Retrospective analysis of prospectively collected MICU data was performed for 5,346 patients admitted to an MICU from January 2004 through January 2007; 3,971 patients were admitted to a resident-run MICU (resident group) and 1,375 to a PA-run MICU (PA group). RESULTS: The groups were relatively similar, though the resident group had a higher rate of renal insufficiency (25% vs. 22%, P = .05) and the PA group had a higher rate of cerebrovascular accidents (5.6% vs. 4%, P = .02). Hospital length of stay (LOS) was similar, with a median of 9 days in the PA group and 8 days in the resident group (P = .59). MICU LOS was slightly longer for the PA group: a median of 2.58 days (1.55-4.86) vs. 2.33 days (1.39-4.16) in the resident group. After matching by propensity score, we could not confirm this increased LOS. There was no difference in hospital mortality or in ICU mortality between the two groups either in uncontrolled or controlled analyses. Survival analyses showed no difference in 28-day survival between the two groups. CONCLUSION: A PA-run MICU has similar outcomes when compared to a resident-run MICU.
Authors: Ruth M Kleinpell; W Robert Grabenkort; April N Kapu; Roy Constantine; Corinna Sicoutris Journal: Crit Care Med Date: 2019-10 Impact factor: 7.598
Authors: David L Carpenter; Sara R Gregg; Daniel S Owens; Timothy G Buchman; Craig M Coopersmith Journal: Crit Care Date: 2012-02-15 Impact factor: 9.097