tailieunhanh - Báo cáo y học: " Intensivists: don’t quit your day job"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Intensivists: don’t quit your day job | Watson and Alarcon Critical Care 2010 14 305 http content 14 2 305 CRITICAL CARE JOURNAL CLUB CRITIQUE L Intensivists don t quit your day Gregory A Watson 1 and Louis H Alarcon1 University of Pittsburgh Department of Critical Care Medicine Evidence-Based Medicine Journal Club edited by Eric B Milbrandt Expanded Abstract Citation Levy 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 . Background Critically 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. Methods Objective To examine the association between hospital mortality in critically ill patients and management by critical care physicians. Design Retrospective analysis of a large prospectively collected database of critically ill patients. Setting 123 ICUs in 100 . hospitals. Subjects 101 832 critically ill adults. Intervention None. Outcomes Through 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. Results Patients who received critical care management CCM were generally sicker received more procedures and had higher hospital mortality rates than those who did not receive CCM. After adjustment for severity of illness and propensity score hospital mortality rates were higher for patients who received CCM than for those who did not. The difference in adjusted hospital mortality rates was less for .