BACKGROUND: With various types of complex patients being treated in a mixed medical- surgical- trauma intensive care unit (ICU), we hypothesized that there should be no difference in patient mortality with respect to the core training of the intensivist. METHODS: We reviewed the cases of all patients admitted to a mixed medical-surgical-trauma ICU at a Canadian university teaching hospital in 2007. Patients were assigned to 1 of 2 treatment groups (internal medicine, surgery/anesthesiology) based on the treating intensivist's training. Our primary outcome was to compare patient mortality in the ICU between the groups. We used generalized estimating equations to determine 10-day mortality after admission to the ICU. A multivariate Cox hazard model was used to determine statistical significance and 95% confidence intervals (CIs) for 11- to 60-day mortality in the ICU. RESULTS: A total of 961 patients were admitted from January to December, 2007. We found no significant difference between the groups in 10-day mortality (odds ratio 0.73, 95% CI 0.46-1.18, p = 0.20) and 11- to 60-day mortality (hazard ratio 1.43, 95% CI 0.62-3.30, p = 0.40) after admission to the ICU. CONCLUSION: In a large university trauma centre that operates a mixed medicine- surgical-trauma ICU, there was no significant difference in mortality between patients managed by intensivists with core training in internal medicine and those managed by intensivists with training in surgery/anesthesiology.
BACKGROUND: With various types of complex patients being treated in a mixed medical- surgical- trauma intensive care unit (ICU), we hypothesized that there should be no difference in patient mortality with respect to the core training of the intensivist. METHODS: We reviewed the cases of all patients admitted to a mixed medical-surgical-trauma ICU at a Canadian university teaching hospital in 2007. Patients were assigned to 1 of 2 treatment groups (internal medicine, surgery/anesthesiology) based on the treating intensivist's training. Our primary outcome was to compare patient mortality in the ICU between the groups. We used generalized estimating equations to determine 10-day mortality after admission to the ICU. A multivariate Cox hazard model was used to determine statistical significance and 95% confidence intervals (CIs) for 11- to 60-day mortality in the ICU. RESULTS: A total of 961 patients were admitted from January to December, 2007. We found no significant difference between the groups in 10-day mortality (odds ratio 0.73, 95% CI 0.46-1.18, p = 0.20) and 11- to 60-day mortality (hazard ratio 1.43, 95% CI 0.62-3.30, p = 0.40) after admission to the ICU. CONCLUSION: In a large university trauma centre that operates a mixed medicine- surgical-trauma ICU, there was no significant difference in mortality between patients managed by intensivists with core training in internal medicine and those managed by intensivists with training in surgery/anesthesiology.
Authors: R J Brilli; A Spevetz; R D Branson; G M Campbell; H Cohen; J F Dasta; M A Harvey; M A Kelley; K M Kelly; M I Rudis; A C St Andre; J R Stone; D Teres; B J Weled Journal: Crit Care Med Date: 2001-10 Impact factor: 7.598
Authors: Derek C Angus; Andrew F Shorr; Alan White; Tony T Dremsizov; Robert J Schmitz; Mark A Kelley Journal: Crit Care Med Date: 2006-04 Impact factor: 7.598
Authors: S S Carson; C Stocking; T Podsadecki; J Christenson; A Pohlman; S MacRae; J Jordan; H Humphrey; M Siegler; J Hall Journal: JAMA Date: 1996 Jul 24-31 Impact factor: 56.272
Authors: A S Multz; D B Chalfin; I M Samson; D R Dantzker; A M Fein; H N Steinberg; M S Niederman; S M Scharf Journal: Am J Respir Crit Care Med Date: 1998-05 Impact factor: 21.405