MONDAY, May 21 (HealthDay News) -- Having so-called intensivist
physicians on staff in intensive care units during the night can
reduce death rates in ICUs that do not have similar coverage during
the day, according to a large new study.
An intensivist is a doctor who specializes in the care of
critically ill patients. ICUs that have intensivists who manage or
co-manage patients during the day are referred to as
high-intensity, while those with optional or no intensivist
involvement are low-intensity.
Previous research showing that high-intensity ICUs have lower
death rates prompted many hospitals to increase the intensivist
presence in their ICUs, including having them there around the
clock, according to a news release from the American Thoracic
The impact of having 24-hour intensivist staffing in ICUs,
however, has not been well studied, said Dr. Jeremy Kahn, an
associate professor of critical care medicine and health policy and
management at the University of Pittsburgh.
Kahn and his colleagues analyzed data from nearly 66,000
patients admitted to 49 ICUs in 25 U.S. hospitals in 2009 and 2010.
Their findings were scheduled for presentation Monday at the
society's international conference in San Francisco and also appear
New England Journal of Medicine.
"Our study indicates that 24-hour intensivists are likely to
improve patient outcomes only in some circumstances," Kahn said in
the news release. "ICUs with low-intensity daytime staffing -- the
most common staffing model in the United States -- have better
outcomes when intensivists are also present at night. Nationally,
two-thirds of ICUs have no intensivists at night, so expanding the
role of intensivists in these ICUs could translate into improved
"Equally important, we found that ICUs with high-intensity
daytime staffing did not share the same benefit from nighttime
intensivists," Kahn added. "These ICUs, which frequently already
have residents and other trainees in the ICU at night, saw no
mortality reduction from the addition of nighttime intensivists.
This shows that the movement to expand intensivist presence in
these hospitals may be premature, especially since intensivists are
in relatively short supply."
The Society of Critical Care Medicine has more about
intensivists and other health providers in the
intensive care unit.