What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?
Authors: Marya D. Zilberberg, Andrew F. Shorr
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?Marya D. Zilberberg, MD and Andrew F. Shorr, MD, MPHMarya D. Zilberberg, MDFrom University of Massachusetts Amherst, Amherst, MA 01003, and Washington Hospital Center, Washington, DC 20010.Search for more papers by this author and Andrew F. Shorr, MD, MPHFrom University of Massachusetts Amherst, Amherst, MA 01003, and Washington Hospital Center, Washington, DC 20010.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-10-200811180-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their study, Levy and colleagues (1) have reported that, on the basis of the data from Project IMPACT, patients managed by intensivists have a higher risk for hospital death than those managed by a noncritical care specialist. Although the authors tried earnestly to remove some of the confounding and heterogeneity by applying adjustments for propensity scores and other variables, they have rightfully acknowledged the possibility of residual confounding. However, other limitations, some acknowledged and others not, impair our interpretation of the results.First, the high number of excluded cases due to missing data predisposes the study ...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. Kahn JM, Kramer AA, and Rubenfeld GD. Transferring critically ill patients out of hospital improves the standardized mortality ratio: a simulation study. Chest. 2007;131:68-75. [PMID: 17218558] CrossrefMedlineGoogle Scholar3. Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, and Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA. 2002;288:2151-62. [PMID: 12413375] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Marya D. Zilberberg, MD; Andrew F. Shorr, MD, MPHAffiliations: From University of Massachusetts Amherst, Amherst, MA 01003, and Washington Hospital Center, Washington, DC 20010.Disclosures: None disclosed. 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? Mitchell M. Levy , John Rapoport , Stan Lemeshow , Gary Phillips , Donald B. Chalfin , and Marion Danis 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? Tihomir Stefanec 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? William T. McGee 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? Thomas L. Higgins , Brian Nathanson , and Daniel Teres Metrics November 18, 2008Volume 149, Issue 10Page: 771-772KeywordsIntensive care unitsPhysiciansSystematic reviews ePublished: 18 November 2008 Issue Published: November 18, 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...