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Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit

PURPOSE: An intensivist is a key factor in the mortality of patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an intensivist on clinical outcomes of patients admitted to a surgical ICU. METHODS: During the study period, the surgical ICU was conve...

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Autores principales: Park, Chi-Min, Chun, Ho-Kyung, Lee, Dae-Sang, Jeon, Kyeongman, Suh, Gee Young, Jeong, Jin Cheol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062451/
https://www.ncbi.nlm.nih.gov/pubmed/24949324
http://dx.doi.org/10.4174/astr.2014.86.6.319
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author Park, Chi-Min
Chun, Ho-Kyung
Lee, Dae-Sang
Jeon, Kyeongman
Suh, Gee Young
Jeong, Jin Cheol
author_facet Park, Chi-Min
Chun, Ho-Kyung
Lee, Dae-Sang
Jeon, Kyeongman
Suh, Gee Young
Jeong, Jin Cheol
author_sort Park, Chi-Min
collection PubMed
description PURPOSE: An intensivist is a key factor in the mortality of patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an intensivist on clinical outcomes of patients admitted to a surgical ICU. METHODS: During the study period, the surgical ICU was converted from an open ICU to an intensivist-directed ICU managed by an intensivist who was board certified in both general surgery and critical care medicine. We compared consecutive patients admitted to the surgical ICU before and after implementing the intensivist-directed care. The primary outcome was ICU mortality, and secondary outcomes were hospital mortality, 90-day mortality, length of hospital stay, ICU-free days, ventilator-free days, and ICU readmission rate. RESULTS: A total of 441 patients were included in this study: 188 before implementation of the intensivist and 253 after implementation. Clinical characteristics were not different between the two groups. ICU mortality decreased from 11.7% to 6.3% (P = 0.047) after implementation, and 90-day mortality also decreased significantly (P = 0.008). The adjusted hazard ratio of the intensivist for ICU mortality was 0.43 (95% confidence interval, 0.22-0.87; P = 0.020). ICU-free days (P = 0.013) and the hospital length of stay (P = 0.032) were significantly improved after implementing the intensivist-directed care. Before implementation period, 16.0% of patients were readmitted, compared with only 9.9% after implementation (P = 0.05). CONCLUSION: Implementing intensivist-directed care in the surgical ICU was associated with significant improvements in ICU mortality and significant clinical outcomes.
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spelling pubmed-40624512014-06-19 Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit Park, Chi-Min Chun, Ho-Kyung Lee, Dae-Sang Jeon, Kyeongman Suh, Gee Young Jeong, Jin Cheol Ann Surg Treat Res Original Article PURPOSE: An intensivist is a key factor in the mortality of patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an intensivist on clinical outcomes of patients admitted to a surgical ICU. METHODS: During the study period, the surgical ICU was converted from an open ICU to an intensivist-directed ICU managed by an intensivist who was board certified in both general surgery and critical care medicine. We compared consecutive patients admitted to the surgical ICU before and after implementing the intensivist-directed care. The primary outcome was ICU mortality, and secondary outcomes were hospital mortality, 90-day mortality, length of hospital stay, ICU-free days, ventilator-free days, and ICU readmission rate. RESULTS: A total of 441 patients were included in this study: 188 before implementation of the intensivist and 253 after implementation. Clinical characteristics were not different between the two groups. ICU mortality decreased from 11.7% to 6.3% (P = 0.047) after implementation, and 90-day mortality also decreased significantly (P = 0.008). The adjusted hazard ratio of the intensivist for ICU mortality was 0.43 (95% confidence interval, 0.22-0.87; P = 0.020). ICU-free days (P = 0.013) and the hospital length of stay (P = 0.032) were significantly improved after implementing the intensivist-directed care. Before implementation period, 16.0% of patients were readmitted, compared with only 9.9% after implementation (P = 0.05). CONCLUSION: Implementing intensivist-directed care in the surgical ICU was associated with significant improvements in ICU mortality and significant clinical outcomes. The Korean Surgical Society 2014-06 2014-05-23 /pmc/articles/PMC4062451/ /pubmed/24949324 http://dx.doi.org/10.4174/astr.2014.86.6.319 Text en Copyright © 2014, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/3.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Park, Chi-Min
Chun, Ho-Kyung
Lee, Dae-Sang
Jeon, Kyeongman
Suh, Gee Young
Jeong, Jin Cheol
Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
title Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
title_full Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
title_fullStr Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
title_full_unstemmed Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
title_short Impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
title_sort impact of a surgical intensivist on the clinical outcomes of patients admitted to a surgical intensive care unit
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062451/
https://www.ncbi.nlm.nih.gov/pubmed/24949324
http://dx.doi.org/10.4174/astr.2014.86.6.319
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