Effect of critical care medicine fellows on patient outcome in the intensive care unit.
BACKGROUND
The impact that physician trainees have on patient outcomes in academic adult medical/surgical intensive care units (ICUs) has not been adequately assessed.


METHODS
All admissions to adult ICUs within the Calgary Health Region over a three-year period when a critical care medicine fellow (CCMF) was on service were compared to when an attending physician was alone on service. Primary outcomes were ICU and in-hospital mortality and length of stay (LOS).


RESULTS
CCMFs and attending physicians admitted 3,341 patients, while attending physicians alone admitted 3,224 patients. There was no difference in ICU or in-hospital mortality between the two groups; regression analysis determined CCMFs did not affect patient LOS.


CONCLUSIONS
In teaching hospitals with adult mixed medical/surgical ICUs, CCMFs do not have an effect on patient outcome or LOS. Improved patient outcomes at academic institutions previously attributed to the presence of CCMFs may instead be due to institution and patient-related factors.
Peets
Adam D
AD
Boiteau
Paul J E
PJ
Doig
Christopher J
CJ
D000416:Alberta; D003422:Critical Care; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007396:Internship and Residency; D007902:Length of Stay; D016014:Linear Models; D012189:Retrospective Studies