Comparison of severity and diagnosis-adjusted mortality rates from pediatric intensive care units (ICUs) staffed by physicians training in pediatric critical care, as well as pediatric residents, with mortality rates from pediatric ICUs staffed with only pediatric residents.
Sixteen volunteer pediatric ICUs, eight with critical care fellowships, and eight without such programs.
Consecutive admissions until at least 14 deaths occurred at each site.
Descriptive data and Pediatric Risk of Mortality scores were collected.
Severity and diagnosis-adjusted mortality risk for each patient was computed by a predictor developed in an independent sample.
The effect of fellowship programs was analyzed at the institution level by ranking the pediatric ICUs in terms of observed/predicted mortality rates, and, at the patient level, by including a training factor into the predictor model.
The use of monitoring and therapeutic modalities was compared in the two types of pediatric ICUs by severity-adjusted odds ratios.
There were 2,744 admissions (145 deaths) to the eight fellowship pediatric ICUs and 3,006 admissions (150 deaths) to the eight nonfellowship pediatric ICUs.
Institutional characteristics were not different between the two pediatric ICU sets.
The raw mortality rates were similar (fellowship 5.28% ; nonfellowship 4.99%, p=714). (...)
Mots-clés Pascal : Soin intensif, Pédiatrie, Unité soin intensif, Mortalité, Taux, Programme enseignement, Formation professionnelle, Médecin, Evaluation, Qualité, Soin, Enfant, Homme, Etats Unis, Amérique du Nord, Amérique, Etude cohorte, Personnel sanitaire
Mots-clés Pascal anglais : Intensive care, Pediatrics, Intensive care unit, Mortality, Rate, Educational program, Occupational training, Physician, Evaluation, Quality, Care, Child, Human, United States, North America, America, Cohort study, Health staff
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0542481
Code Inist : 002B30A09. Création : 24/03/1998.