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Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury

OBJECTIVES: To determine the relationship between emergent intubation (emergency department and field intubation cases combined) and mortality in patients with traumatic brain injury while controlling for injury severity. METHODS: Retrospective observational study of 981 (35.2% intubated, 64.8% not...

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Autores principales: Denninghoff, Kurt R., Griffin, Mervin J., Bartolucci, Alfred A., LoBello, Steven G., Fine, Phillip R.
Formato: Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672276/
https://www.ncbi.nlm.nih.gov/pubmed/19561742
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author Denninghoff, Kurt R.
Griffin, Mervin J.
Bartolucci, Alfred A.
LoBello, Steven G.
Fine, Phillip R.
author_facet Denninghoff, Kurt R.
Griffin, Mervin J.
Bartolucci, Alfred A.
LoBello, Steven G.
Fine, Phillip R.
author_sort Denninghoff, Kurt R.
collection PubMed
description OBJECTIVES: To determine the relationship between emergent intubation (emergency department and field intubation cases combined) and mortality in patients with traumatic brain injury while controlling for injury severity. METHODS: Retrospective observational study of 981 (35.2% intubated, 64.8% not intubated) patients with TBI evaluating the association between intubation status and mortality. Logistic regression was used to analyze the data. Injury severity measures included Head/Neck Abbreviated Injury Scale (H-AIS), systolic blood pressure, type of head injury (blunt vs. penetrating), and a propensity score combining the effects of several other potential confounding variables. Age was also included in the model. RESULTS: The simple association of emergent endotracheal intubation with death had an odds ratio (OR) of 14.3 (95% CI = 9.4–21.9). The logistic regression model including relevant covariates and a propensity score that adjusted for injury severity and age yielded an OR of 5.9 (95% CI = 3.2–10.9). CONCLUSIONS: This study indicates that emergent intubation is associated with increased risk of death after controlling for a number of injury severity indicators. We discuss the need for optimal paramedic training, and an understanding of the factors that guide patient selection and the decision to intubate in the field.
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spelling pubmed-26722762009-06-24 Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury Denninghoff, Kurt R. Griffin, Mervin J. Bartolucci, Alfred A. LoBello, Steven G. Fine, Phillip R. West J Emerg Med Critical Care OBJECTIVES: To determine the relationship between emergent intubation (emergency department and field intubation cases combined) and mortality in patients with traumatic brain injury while controlling for injury severity. METHODS: Retrospective observational study of 981 (35.2% intubated, 64.8% not intubated) patients with TBI evaluating the association between intubation status and mortality. Logistic regression was used to analyze the data. Injury severity measures included Head/Neck Abbreviated Injury Scale (H-AIS), systolic blood pressure, type of head injury (blunt vs. penetrating), and a propensity score combining the effects of several other potential confounding variables. Age was also included in the model. RESULTS: The simple association of emergent endotracheal intubation with death had an odds ratio (OR) of 14.3 (95% CI = 9.4–21.9). The logistic regression model including relevant covariates and a propensity score that adjusted for injury severity and age yielded an OR of 5.9 (95% CI = 3.2–10.9). CONCLUSIONS: This study indicates that emergent intubation is associated with increased risk of death after controlling for a number of injury severity indicators. We discuss the need for optimal paramedic training, and an understanding of the factors that guide patient selection and the decision to intubate in the field. Department of Emergency Medicine, University of California, Irvine School of Medicine 2008-11 /pmc/articles/PMC2672276/ /pubmed/19561742 Text en Copyright © 2008 the authors. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Critical Care
Denninghoff, Kurt R.
Griffin, Mervin J.
Bartolucci, Alfred A.
LoBello, Steven G.
Fine, Phillip R.
Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
title Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
title_full Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
title_fullStr Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
title_full_unstemmed Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
title_short Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
title_sort emergent endotracheal intubation and mortality in traumatic brain injury
topic Critical Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672276/
https://www.ncbi.nlm.nih.gov/pubmed/19561742
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