Influence of Specialization from Intensive Care Physicians on Outcome in Multiply Injured Patients-A Matched-Pair Analysis at a Level I Trauma Center.

The specialty background of intensive physicians managing severely injured patients varies internationally, with trauma ICUs often led by either trauma surgeons or anesthesiologists, both of whom receive additional intensive care training. Whether physician specialty affects outcomes remains uncertain. We conducted a retrospective single-center cohort study of patients aged ≥ 16 years with an Injury Severity Score (ISS) ≥ 16 admitted to a level I trauma center between January 2005 and December 2022. Patients were treated either in a trauma surgery ICU (T-ICU) or an anesthesiology ICU (A-ICU). Briefly, 1:1 matching was conducted based on demographic and injury-related variables, with the primary outcome being in-hospital mortality and secondary outcomes including transfusion requirements, duration of mechanical ventilation, ICU and hospital length of stay, and Glasgow Outcome Scale (GOS) at discharge. Among the 1015 eligible patients (T-ICU: n = 920; A-ICU: n = 95), 52 patients (26 per group) were successfully matched with comparable baseline characteristics. No significant differences were observed in mortality, GOS, transfusion requirements, ventilation duration, or ICU/hospital length of stay. These findings suggest that, when both are led by certified intensive care specialists, trauma surgery- and anesthesiology-based ICUs achieve comparable outcomes, supporting multidisciplinary models while highlighting the need for larger multicenter studies.