| Can the experienced ICU physician predict ICU length of stay and outcome better than less experienced colleagues? | |
| | |
MedLine Citation:
|
PMID: 14735235 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To assess the ability of physicians with varying degrees of experience to predict the length of stay and outcome of intensive care unit (ICU) patients. DESIGN: Prospective, interview-based study. SETTING: A 31-bed mixed medical-surgical ICU. PATIENTS: A total of 223 consecutive patients (excluding those admitted for routine post-operative surveillance) admitted to the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Physicians immediately responsible for each patient, and others fully aware of the case, were interviewed separately during the first 12 h of ICU admission to determine their assessment of the patient's likely duration of stay on the ICU and the probable outcome. Degree of predictive accuracy was assessed using the Kappa statistic with kappa < or =0.2 poor, 0.21-0.4 fair, 0.41-0.60 moderate, 0.61-0.8 good, and 0.81-1.0 very good. Physicians were graded according to their degree of experience as junior (less than 1 year ICU experience), medium (critical care fellow), and senior (staff physician with supervising functions). For lengths of stay less than 5 days, senior physicians were better predictors than less experienced doctors. For outcome prediction, physicians were generally moderately good at predicting death, with senior physicians tending to be more accurate than their less experienced colleagues (senior kappa 0.68, medium kappa 0.52, junior kappa 0.43). CONCLUSIONS: Prediction of length of ICU stay was poor amongst all physicians in patients with a length of stay greater than 5 days. Experienced physicians were better predictors of ICU lengths of stay less than 5 days and, in contrast to some reports, of ICU outcome than their more inexperienced counterparts. |
| | |
Authors:
|
Fábio Gusmão Vicente; Frederico Polito Lomar; Christian Mélot; Jean-Louis Vincent |
Related Documents
:
|
1395555 - Assessing need for extended psychiatric hospitalization. 16509905 - Determinants of good outcome in pyloric stenosis. 10135605 - Use of severity-adjusted length of stay to modify physician practice patterns. 15201365 - A cohort study of early neurological consultation by telemedicine on the care of neurol... 20209695 - Extrapulmonary tuberculosis: a retrospective review of 194 cases at a tertiary care hos... 21519775 - The burden of hospital malnutrition in spain: methods and development of the predyces®... |
Publication Detail:
|
Type: Journal Article Date: 2004-01-21 |
Journal Detail:
|
Title: Intensive care medicine Volume: 30 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2004 Apr |
Date Detail:
|
Created Date: 2004-03-31 Completed Date: 2004-10-21 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 655-9 Citation Subset: IM |
Affiliation:
|
:Department of Intensive Care Unit, Erasme Hospital Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Clinical Competence / standards Female Humans Intensive Care Intensive Care Units* Length of Stay Male Middle Aged Physicians / classification, standards* Prognosis Prospective Studies Questionnaires Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Preliminary in vivo pharmacokinetic and pharmacodynamic evaluation of a novel calcineurin-independen...
Next Document: Albumin dialysis: a new therapeutic strategy for intoxication from protein-bound drugs.