What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?
Authors: Michael Blumhardt
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?Michael Blumhardt, MDMichael Blumhardt, MDFrom Mercy Regional Medical Center, Durango, CO 81301.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-10-200811180-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The study by Levy and colleagues (1) found an association between CCM and increased mortality. This follows the recent publication of the Dartmouth Health Atlas 2008 (2) and associated commentary in the New England Journal of Medicine(3). The Dartmouth study reviewed the records of several million Medicare patients hospitalized during the last 2 years of life at nearly 3000 hospitals. Levy and colleagues' study and the Dartmouth study both offer unfavorable appraisals of critical and end-of-life care as practiced today.Citing wide disparities in end-of-life care expenditures, the authors of the Dartmouth study argue that such differences ...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. Wennberg JE, Fisher ES, Goodman DC, Skinner JS. Tracking the Care of Patients with Severe Chronic Illness: The Dartmouth Health Atlas 2008. Executive Summary. Lebanon, NH: The Trustees of Dartmouth College; 2008. Accessed at www.dartmouthatlas.org/atlases/2008_Atlas_Exec_Summ.pdf on 8 October 2008. Google Scholar3. Goodman DC and Fisher ES. Physician workforce crisis? Wrong diagnosis, wrong prescription. N Engl J Med. 2008;358:1658-61. [PMID: 18420498] CrossrefMedlineGoogle Scholar4. Halpern NA, Pastores SM, Thaler HT, and Greenstein RJ. Critical care medicine use and cost among Medicare beneficiaries 1995-2000: major discrepancies between two United States federal Medicare databases. Crit Care Med. 2007;35:692-9. [PMID: 17255850] CrossrefMedlineGoogle Scholar5. Dennison CR, Mendez-Tellez PA, Wang W, Pronovost PJ, and Needham DM. Barriers to low tidal volume ventilation in acute respiratory distress syndrome: survey development, validation, and results. Crit Care Med. 2007;35:2747-54. [PMID: 17901838] CrossrefMedlineGoogle Scholar6. Carlbom DJ and Rubenfeld GD. Barriers to implementing protocol-based sepsis resuscitation in the emergency departmentresults of a national survey. Crit Care Med. 2007;35:2525-32. [PMID: 18075366] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mercy Regional Medical Center, Durango, CO 81301.Disclosures: Dr. Blumhardt is a practicing critical care physician. 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Cely 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: 768KeywordsCritical careEvidence based medicineIntensive care unitsMedicareResuscitationRisk managementSepsis ePublished: 18 November 2008 Issue Published: November 18, 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...