title: The impact of intensivists' base specialty of training on care process and outcomes of critically ill trauma patients.
abstract: BACKGROUND
  The care of the critically ill trauma patients is provided by intensivists with various base specialties of training. The purpose of this study was to investigate the impact of intensivists' base specialty of training on the disparity of care process and patient outcome.
  
  
  METHODS
  We performed a retrospective review of an institutional trauma registry at an academic level 1 trauma center. Two intensive care unit teams staffed by either board-certified surgery or anesthesiology intensivists were assigned to manage critically ill trauma patients. Both teams provided care, collaborating with a trauma surgeon in house. We compared patient characteristics, care processes, and outcomes between surgery and anesthesiology groups using Wilcoxon tests or chi-square tests, as appropriate.
  
  
  RESULTS
  We identified a total of 620 patients. Patient baseline characteristics including age, sex, transfer status, injury type, injury severity score, and Glasgow coma scale were similar between groups. We found no significant difference in care processes and outcomes between groups. In a logistic regression model, intensivists' base specialty of training was not a significant factor for mortality (odds ratio, 1.46; 95% confidence interval; 0.79-2.80; P = 0.22) and major complication (odds ratio, 1.11; 95% confidence interval, 0.73-1.67; P = 0.63).
  
  
  CONCLUSIONS
  Intensive care unit teams collaborating with trauma surgeons had minimal disparity of care processes and similar patient outcomes regardless of intensivists' base specialty of training.
authors.affiliation: Division of Trauma, Acute Care and Critical Care Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17036, USA. kmatsushima@hmc.psu.edu
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Matsushima
authors.forename: Eleanor R
authors.initials: ER
authors.lastname: Goldwasser
authors.forename: Eric W
authors.initials: EW
authors.lastname: Schaefer
authors.forename: Scott B
authors.initials: SB
authors.lastname: Armen
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Indeck
mesh_terms: D000328:Adult; D000368:Aged; D000776:Anesthesiology / Q000193:education / Q000458:organization & administration; D002568:Certification; D003422:Critical Care / Q000458:organization & administration; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D013502:General Surgery / Q000193:education / Q000458:organization & administration; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000458:organization & administration; D016015:Logistic Models; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education* / Q000458:organization & administration; D008511:Medicine / Q000458:organization & administration*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers / Q000458:organization & administration; D000078329:Workforce; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*
keywords: Base specialty of training; Care process; Critically ill trauma patient; Intensivist; Outcome