संज्ञानश्वासन और निदान शोध जर्नल
खुला एक्सेस

अमूर्त

Impact of Intensive Care Unit Physician on Care Processes of Patients with Severe Sepsis in Teaching Hospitals

Takeshi Umegaki, Miho Sekimoto and Yuichi Imanaka

Objective: The purpose of the study was to investigate associations among intensive care unit (ICU) staffing and care processes in patients with severe sepsis.

Design: An observational multicenter cross-sectional study performed from October 2007 to March 2008.

Setting: Forty-nine teaching hospitals in Japan.

 Participants: Patients (n=576) with severe sepsis identified using ICD-10 codes from administrative data.

Main outcome measures: Care processes including mechanical ventilation, dialysis, enteral feeding, parentetal nutrition, and antibiotic empirical therapy which were available in administrative data.

Results: ICUs were classified as high- or low-intensity based on policies regarding the responsibilities of intensivists. There were no differences in baseline patient characteristics between the ICU groups. In the high-intensity group, ICU stay for survivors was about two days shorter and hospital stay was significantly shorter by three days. Majority of patients had high rates of enteral feeding; however, the high-intensity group had significantly earlier initiation of enteral feeding and a significantly shorter duration of mechanical ventilation. A shorter duration of mechanical ventilation was significantly associated with the ICU structure.

Conclusions: The results showed an association between ICU physician and processes of intensive care, and high-intensity ICU was aggressive in mechanical ventilation in patients with severe sepsis.