Pediatric Intensivist Coverage and Outcomes in Critically Ill Children: A Cohort Study

Area of Science:

• Pediatric critical care medicine
• Intensive care unit (ICU) management
• Public health outcomes

Background:

• The effect of trained intensivist staffing on critically ill pediatric patients in intensive care units (ICUs) remains unclear.
• Assessing the impact of specialized physician coverage is crucial for optimizing pediatric critical care.

Purpose of the Study:

• To determine if trained intensivist coverage is associated with better survival outcomes in critically ill pediatric patients.
• To evaluate the impact of dedicated pediatric intensivist staffing on mortality rates.

Main Methods:

• Analysis of pediatric patients admitted to South Korean ICUs between 2017 and 2021.
• Comparison of mortality rates between pediatric ICU patients in hospitals with and without trained intensivists.
• Propensity score matching used to create comparable intensivist and nonintensivist groups for final analysis.

Main Results:

• The study included 28,047 pediatric patients; 16,992 were analyzed after propensity score matching.
• The intensivist group (n=8496) had lower 90-day (6.7% vs 8.6%) and 1-year (8.3% vs 9.8%) all-cause mortality rates compared to the nonintensivist group (n=8496).
• Cox regression analysis revealed a 24% lower 90-day mortality (HR, 0.76) and a 17% lower 1-year mortality (HR, 0.83) in the intensivist group.

Conclusions:

• The presence of pediatric intensivists in the ICU significantly reduces mortality among critically ill pediatric patients.
• Findings underscore the critical role of pediatric intensivists in improving long-term survival for critically ill children.
• Implementing dedicated pediatric intensivist programs may enhance patient outcomes in critical care settings.