• Punkaj Gupta, Xinyu Tang, Mallikarjuna Rettiganti, Casey Lauer, Robert M Kacmarek, Tom B Rice, Barry P Markovitz, and Randall C Wetzel.
• Division of Pediatric Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
• Acta Paediatr. 2016 Feb 1; 105 (2): e60-6.

AimTo evaluate the association of house staff training with mortality in children with critical illness.MethodsPatients <18 years of age in the Virtual PICU Systems (VPS, LLC) Database (2009-2013) were included. The study population was divided in two study groups: hospitals with residency programme only and hospitals with both residency and fellowship programme. Control group constituted hospitals with no residency or fellowship programme. The primary study outcome was mortality before intensive care unit (ICU) discharge. Multivariable logistic regression models were fitted to evaluate association of training programmes with ICU mortality.ResultsA total of 336 335 patients from 108 centres were included. Case-mix of patients among the hospitals with training programmes was complex; patients cared for in the hospitals with training programmes had greater severity of illness, had higher resource utilisation and had higher overall admission risk of death compared to patients cared for in the control hospitals. Despite caring for more complex and sicker patients, the hospitals with training programmes were associated with lower odds of ICU mortality.ConclusionOur study establishes that ICU care provided in hospitals with training programmes is associated with improved adjusted survival rates among the Virtual PICU database hospitals in the United States.©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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