Intensivist staffing on night of admission also has no effect on ICU mortality, other end points
MONDAY, May 20 (HealthDay News) -- Nighttime intensivist staffing in the intensive care unit (ICU) on the day of admission is not associated with reduced length of stay in the ICU and does not improve other patient outcomes, according to a study published online May 20 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17 to 22 in Philadelphia.
Meeta Prasad Kerlin, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a one-year randomized trial in an academic medical ICU to compare the effects of nighttime staffing with in-hospital intensivists (intervention) versus nighttime coverage by daytime intensivists who were available for telephone consultation (control). Blocks of seven consecutive nights were randomly assigned to the intervention or control strategy. Analyses included 1,598 patients.
The researchers found that, compared with patients admitted on control days, patients who were admitted on intervention days were exposed to nighttime intensivists on more nights (median, 100 versus 0 percent of nights). Intensivist staffing on the night of admission had no significant effect on the ICU length of stay, ICU mortality, or any other end point. Similar results were seen in analyses restricted to patients who were admitted at night.
"In an academic medical ICU in the United States, nighttime in-hospital intensivist staffing did not improve patient outcomes," the authors write.
Abstract (http://www.nejm.org/doi/full/10.1056/NEJMoa1302854#t=abstract )Full Text (http://www.nejm.org/doi/full/10.1056/NEJMoa1302854#t=article )More Information (http://conference.thoracic.org/2013/ )