24/7 intensivist in pediatric ICU improves patient outcomes

(HealthDay)—Having a 24/7 intensivist in pediatric intensive care units (ICUs) is associated with improved patient outcomes, according to a study published in the Dec. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Punkaj Gupta, M.D., from the University of Arkansas for Medical Sciences in Little Rock, and colleagues used data (455,607 patients from 125 hospitals) from the Virtual Pediatric Systems Database (2009 to 2014) to assess the association of 24/7 in-house coverage with outcomes in children with critical illness.

The researchers found that after adjusting for patient and center characteristics, the 24/7 group was associated with lower mortality in the intensive care unit (ICU), compared to the no-24/7 group (odds ratio [OR], 0.52; P = 0.002). Around-the-clock coverage was also associated with a lower incidence of cardiac arrest (OR, 0.73; P = 0.04), lower mortality after cardiac arrest (OR, 0.56; P = 0.02), a shorter ICU stay (mean difference, −0.51 days), and shorter duration of mechanical ventilation (mean difference, −0.68 days).

"We demonstrated that pediatric critical care provided in the ICUs staffed with a 24/7 intensivist presence is associated with improved overall patient survival and survival after cardiac arrest compared with patients treated in ICUs staffed with discretionary attending coverage," the authors write.