title: Appropriate medical professionals communication reduces intensive care unit mortality.
abstract: OBJECTIVE
  Communication issues between healthcare professionals in intensive care units may be related to critically ill patients increased mortality. This study aimed to evaluate if communication issues involving assistant physicians and routine intensive care unit physicians would impact critically ill patients morbidity and mortality.
  
  
  METHODS
  This was a cohort study that included non-consecutive patients admitted to the intensive care unit for 18 months. The patients were categorized in 3 groups according to their assistant doctors versus routine doctors communication uses: DC - daily communication during the stay (>75% of the days); EC - eventual communication (25 to 75% of the days); RC - rare communication (< 25% of the days). Demographic data, severity scores, reason for admission to the intensive care unit and interventions were recorded. The consequences of the medical professionals communication failures (delayed procedures, diagnostic tests, antibiotics, ventilatory weaning, vasopressors) and medical prescriptions inadequacies (no bed head elevation, no stress ulceration and deep venous thrombosis drug prophylaxis), and their relationship with the patients outcomes were analyzed.
  
  
  RESULTS
  792 patients were included, and categorized as follows: DC (n=529); EC (n=187) and RC (n=76). The mortality was increased in the RC patients group (26.3%) versus the remainder groups (DC = 13.6% and EC = 17.1%; p<0.05). A multivariate analysis showed that delayed antibiotics [RR 1.83 (CI95%: 1.36 -2.25)], delayed ventilatory weaning [RR 1.63 (CI95%: 1.25-2.04)] and no deep venous thrombosis prophylaxis [RR 1.98 (CI95%: 1.43 - 3.12)] contributed independently for the increased mortality.
  
  
  CONCLUSIONS
  The failure in the assistant and routine intensive care doctors communication may increase the patients mortality, particularly due to delayed antibiotics and ventilation weaning, and lack of deep venous thrombosis prophylaxis prescription.
authors.affiliation: Centro de Tratamento Intensivo de Adultos, Hospital Moinhos de Vento de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Cassiano
authors.initials: C
authors.lastname: Teixeira
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Terezinha Marlene Lopes
authors.initials: TM
authors.lastname: Teixeira
authors.affiliation: Centro de Tratamento Intensivo de Adultos, Hospital Moinhos de Vento de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Sérgio Fernando Monteiro
authors.initials: SF
authors.lastname: Brodt
authors.affiliation: Centro de Tratamento Intensivo de Adultos, Hospital Moinhos de Vento de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Roselaine Pinheiro
authors.initials: RP
authors.lastname: Oliveira
authors.affiliation: Terapia Intensiva, Hospital Moinhos de Vento de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Felippe Leopoldo
authors.initials: FL
authors.lastname: Dexheimer Neto
authors.affiliation: Terapia Intensiva, Hospital Moinhos de Vento de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Cíntia
authors.initials: C
authors.lastname: Roehrig
authors.affiliation: Centro de Tratamento Intensivo de Adultos, Hospital Moinhos de Vento de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Eubrando Silvestre
authors.initials: ES
authors.lastname: Oliveira