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호흡기 내과계 중환자실 전공의 수와 중환자실 사망률의 관련성
이병준 ( Byoung Jun Lee ),이창훈 ( Chang Hoon Lee ),김덕겸 ( Deog Kyeom Kim ),김경희 ( Kyoung Hee Kim ),김은선 ( Eun Sun Kim ),박태연 ( Tae Yun Park ),정근범 ( Keun Bum Chung ),강효재 ( Hyo Jae Kang ),정윤정 ( Yun Jeong Jeong ) 대한내과학회 2010 대한내과학회지 Vol.79 No.2
Background/Aims: The treatment outcome of patients hospitalized in intensive care units (ICUs) can be influenced by physician factors, including both intensivists and resident physicians. We evaluated the association between the number of residents who are exclusively responsible for the ICU and the mortality rate in a medical ICU. Methods: The data obtained from an open medical ICU in a teaching hospital from Jan. 2005 to Dec. 2009 were analyzed retrospectively. We evaluated the associations between the ICU mortality rate and both the number of resident physicians and the number of patient-days per resident physician using multivariate Poisson regression analysis adjusted for year and month. Results: The months with fewer than two residents tended to have a higher ICU mortality rate, although this difference was not significant in the univariate analyses. Multivariate Poisson regression analysis showed that months with fewer than two residents had a significantly higher ICU mortality rate compared with months with two residents (incidence risk ratio (IRR) 1.59, 95% confidence interval (CI) 1.05-2.41; p=0.029). The number of ICU patient-days per resident physician was not associated with the ICU mortality rate (IRR; 1.00, 95% CI, 0.99-1.01; p=0.649). Conclusions: The presence of fewer than two residents exclusively responsible for the medical ICU was an independent risk factor of a higher ICU mortality rate. However, no association was found between the number of ICU patient-days per resident physician and the ICU mortality rate. (Korean J Med 79:155-162, 2010)
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