What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?
Authors: Thomas L. Higgins, Brian Nathanson, Daniel Teres
Journal: Annals of Internal Medicine (2008)

LettersNovember 18, 2008What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?Thomas L. Higgins, MD, MBA, Brian Nathanson, PhD, and Daniel Teres, MDThomas L. Higgins, MD, MBAFrom Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199; OptiStatim LLC, Longmeadow, MA 01106; and Tufts University School of Medicine, Boston, MA 02111., Brian Nathanson, PhDFrom Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199; OptiStatim LLC, Longmeadow, MA 01106; and Tufts University School of Medicine, Boston, MA 02111., and Daniel Teres, MDFrom Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199; OptiStatim LLC, Longmeadow, MA 01106; and Tufts University School of Medicine, Boston, MA 02111.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-10-200811180-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We were intrigued by the results of Levy and colleagues' study (1), which demonstrated higher odds for hospital mortality in patients managed by critical care physicians. We recently used the Project IMPACT database (Cerner, Kansas City, Missouri) to update the Mortality Probability Model (MPM). Although our sample of 124885 patients at 98 hospitals between October 2001 and March 2004 is not identical, the overlap is substantial. We analyzed the variable, Percentage of patient stay managed by critical care physician/team. In our sample, 68179 patients (54.6%) were coded as 0% critical care management (CCM), 50694 (40.6%) were coded ...References1. 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;148:801-9 LinkGoogle Scholar2. Higgins TL, Teres D, Copes WS, Nathanson BH, Stark M, and Kramer AA. Assessing contemporary intensive care unit outcome: an updated Mortality Probability Admission Model (MPM0-III). Crit Care Med. 2007;35:827-35. [PMID: 17255863] CrossrefMedlineGoogle Scholar3. Higgins TL, Brennan M, Jodka P, Teres D, and Nathanson B. Elderly patients without MPM-III risk factors fare surprisingly well. Crit Care Med. 2007;35:A171. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199; OptiStatim LLC, Longmeadow, MA 01106; and Tufts University School of Medicine, Boston, MA 02111.Disclosures:Consultancies: T.L. Higgins (Cerner), B. Nathanson (Cerner). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit Mitchell M. Levy , John Rapoport , Stanley Lemeshow , Donald B. Chalfin , Gary Phillips , and Marion Danis What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Andrew A. Quartin , Roland M.H. Schein , and Cynthia M. Cely What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Michael Blumhardt What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Joris J. Arends and Jan P. Vandenbroucke What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Tihomir Stefanec What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? William T. McGee What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Constantine Manthous and Yaw Amoateng-Adjepong What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Paul Marik , John Myburgh , Djillali Annane , Jean-Louis Vincent , Stephen Pastores , G. Umberto Meduri , and Albertus Beishuizen What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Marya D. Zilberberg and Andrew F. Shorr What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? Mitchell M. Levy , John Rapoport , Stan Lemeshow , Gary Phillips , Donald B. Chalfin , and Marion Danis Metrics November 18, 2008Volume 149, Issue 10Page: 767KeywordsAlcoholsCritical careDatabasesDeath ratesElderlyMedical risk factorsPhysiciansRetrospective studiesSurgery ePublished: 18 November 2008 Issue Published: November 18, 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...