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Impact of intensive care unit attending physician training background on outcomes in children undergoing heart

Priya Bhaskar1, Mallikarjuna Rettiganti2, Jeffrey M Gossett2

  • 1Division of Pediatric Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Annals of Pediatric Cardiology
|February 15, 2018
PubMed

Insights

Physician training background in pediatric cardiac intensive care units (ICUs) did not impact patient outcomes after heart surgery. This study found no significant differences in mortality or other key outcomes based on attending physician specialization.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pediatric Cardiology
  • Healthcare Outcomes Research

Background:

  • Pediatric cardiac intensivist training pathways are diverse, with physicians originating from pediatric critical care, cardiology, neonatology, or anesthesia.
  • Variability in training backgrounds may influence care quality and patient outcomes.

Purpose of the Study:

  • To investigate the association between the training background of pediatric cardiac Intensive Care Unit (ICU) attending physicians and patient outcomes.
  • To determine if specialization in critical care medicine versus cardiology impacts outcomes in pediatric cardiac surgery patients.

Main Methods:

  • Analysis of a large dataset (2010-2015) of pediatric patients (1 day to 18 years) undergoing heart operations.
  • ICUs were categorized based on the predominant training background of attending physicians: critical care medicine (CCM), cardiology, or indeterminate.
  • Multivariable logistic regression models were used to assess the relationship between ICU attending physician training and patient outcomes.

Main Results:

  • A total of 54,935 patients from 42 ICUs were included in the study.
  • No significant difference in mortality was observed between patients treated in CCM-majority ICUs versus cardiology-majority ICUs (OR: 0.75, 95% CI: 0.48-1.18).
  • No specific ICU attending physician training background was associated with lower rates of cardiac arrest, prolonged hospital stay, or extended mechanical ventilation.

Conclusions:

  • This extensive observational study found no evidence that the training background of ICU attending physicians affects outcomes in children undergoing heart operations.
  • The findings suggest that physicians from various backgrounds can provide comparable care in pediatric cardiac ICUs.
Abstract

Keywords:
Cardiac intensive carechildrenmortalitytraining background

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