"Intensive Care Unit Dedicated Specialists Can Reduce ICU Mortality Rate by 22%"

Seong In-ae and Oh Tak-gyu's Team at Bundang Seoul National University Hospital
Improving Survival Rates of COVID-19 and Acute Respiratory Distress Syndrome
"Adequate Compensation Needed to Expand Dedicated Specialists"

A study has found that having dedicated intensivists in intensive care units (ICUs) can reduce ICU mortality rates. This suggests the need to employ dedicated intensivists to improve patient survival rates.

The research team led by Professors Song In-ae and Oh Tak-gyu from the Department of Anesthesiology and Pain Medicine at Bundang Seoul National University Hospital confirmed this through a comparative study on ICU mortality rates depending on the presence of dedicated intensivists, announced on the 13th.

Professor Takgyu Oh (left) and Professor Inae Song, Department of Anesthesiology and Pain Medicine, Bundang Seoul National University Hospital.

The dedicated intensivist system involves intensivists specializing in critical care medicine being stationed in the ICU during weekday daytime hours for at least five days a week, allowing for expert advice on patient conditions and rapid decision-making regarding treatment directions. Since the Korean Society of Critical Care Medicine first introduced the dedicated intensivist system and training program in 2009, there were 1,774 dedicated intensivists in Korea as of last year.

The research team used data from the National Health Insurance Service to compare mortality rates of 1,147,493 patients admitted to ICUs from 2016 to 2019 and 13,103 patients admitted to ICUs due to COVID-19 from October 2020 to December 2021, based on the presence of dedicated intensivists. ICU patients were categorized from those not requiring oxygen therapy (grade 1) to those needing vasopressors, dialysis, or extracorporeal membrane oxygenation (ECMO) (grade 6), including those diagnosed with acute respiratory distress syndrome (ARDS), and mortality rates were analyzed accordingly.

As a result, the proportion of critically ill patients treated by dedicated intensivists was 42% from 2016 to 2019 and 20.2% from 2020 to 2021. ICU mortality rates for patients treated by dedicated intensivists decreased by an average of 22% compared to those not treated by them, and one-year mortality rates decreased by 15%. Additionally, mortality rates for patients admitted to ICUs due to COVID-19 decreased by an average of 28%. Notably, mortality rates for ARDS patients, who have poor prognoses and high mortality, decreased by 36%.

Professor Oh Tak-gyu stated, "Dedicated intensivists provide expert advice on patient evaluation and treatment direction within the golden hour, significantly reducing mortality rates. To increase ICU survival rates, employing dedicated intensivists should be considered. Especially since critical care is one of the essential medical fields that young doctors nowadays tend to avoid due to excessive workload and litigation risks, the number of doctors willing to become dedicated intensivists is decreasing, making policy support even more necessary." Professor Song In-ae added, "Because compensation for employing dedicated intensivists is not substantial, few hospitals consider hiring them. Sufficient compensation policies are needed to expand the number of dedicated intensivists."

The comparative study on mortality rates depending on the presence of dedicated intensivists was published in the SCI journal Annals of Intensive Care, and the study comparing mortality rates in COVID-19 ICU patients based on the presence of dedicated intensivists was published in the official publication of the Japanese Society of Intensive Care Medicine, the SCI journal Journal of Intensive Care.

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