It is thought that extremely sick patients who are admitted to intensive care units (ICUs) gain a survival benefit if they are managed by critical care physicians. You might be surprised to hear that new research reported in a recent issue of the Annals of Internal Medicine indicated that critically ill patients who were managed by intensive care doctors were more likely to die than those managed by other physicians who were not specially trained in critical care.

The researchers analyzed data from 101,832 critically ill patients in 123 ICUs in 100 U.S. hospitals. They found that patients who received critical care management were generally sicker, underwent more medical procedures, and had higher hospital mortality rates than those who did not receive intensive care management. Even after adjusting for the severity of a patient's illness, the researchers still found that the mortality rate was higher for patients who received critical care management.

The researchers suggest that one possible explanation might be that intensive care physicians are more likely than other physicians to deviate from standard protocols or to perform more medical procedures which increase the risk of complications. Keeping in mind that previous studies have shown a survival benefit with critical care management, additional studies are needed to further validate these unexpected findings and convincingly elucidate the reasons why critical care management might increase hospital mortality.