Critical Care Specialists in the ICU May Not Be the Answer

Intensive care unit (ICU) patients whose care is managed by ‘intensivists’ have a higher mortality rate than those managed otherwise, according to a report in the Annals of Internal Medicine.
Rhode Island researchers examined hospital mortality in over 100,000 patients from 123 ICUs across the USA. They compared the outcomes in the patients managed by physicians who were critical care specialists with those who were not. Patients managed by these ‘intensivists’ were generally sicker and received more procedures.

After adjustments were made for disease severity, there was still a higher mortality among patients managed by the intensivists. The study authors say that their results are “surprising and completely contrary to previously published findings." They speculate that there may be unknown confounding factors, such as more procedures leading to more complications, or communication problems between different physicians treating the intensivist-assigned patients. Further studies of the differences and implementation of care between the two groups of patients may reveal a reason for these findings.

In the meantime – who would you prefer to have in charge when you land in the ICU? An intensivist or a ‘regular’ physician?