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In-hospital mortality after prehospital endotracheal intubation versus alternative methods of airway management in trauma patients. A cohort study from the TraumaRegister DGU®.
- Source :
- European Journal of Trauma & Emergency Surgery; Aug2024, Vol. 50 Issue 4, p1637-1647, 11p
- Publication Year :
- 2024
-
Abstract
- Purpose: Prehospital airway management in trauma is a key component of care and is associated with particular risks. Endotracheal intubation (ETI) is the gold standard, while extraglottic airway devices (EGAs) are recommended alternatives. There is limited evidence comparing their effectiveness. In this retrospective analysis from the TraumaRegister DGU®, we compared ETI with EGA in prehospital airway management regarding in-hospital mortality in patients with trauma. Methods: We included cases only from German hospitals with a minimum Abbreviated Injury Scale score ≥ 2 and age ≥ 16 years. All patients without prehospital airway protection were excluded. We performed a multivariate logistic regression to adjust with the outcome measure of hospital mortality. Results: We included n = 10,408 cases of whom 92.5% received ETI and 7.5% EGA. The mean injury severity score was higher in the ETI group (28.8 ± 14.2) than in the EGA group (26.3 ± 14.2), and in-hospital mortality was comparable: ETI 33.0%; EGA 30.7% (27.5 to 33.9). After conducting logistic regression, the odds ratio for mortality in the ETI group was 1.091 (0.87 to 1.37). The standardized mortality ratio was 1.04 (1.01 to 1.07) in the ETI group and 1.1 (1.02 to 1.26) in the EGA group. Conclusions: There was no significant difference in mortality rates between the use of ETI or EGA, or the ratio of expected versus observed mortality when using ETI. [ABSTRACT FROM AUTHOR]
- Subjects :
- WOUNDS & injuries
PATIENTS
MULTIPLE regression analysis
TRAUMA severity indices
LOGISTIC regression analysis
FISHER exact test
HOSPITAL mortality
EMERGENCY medicine
EMERGENCY medical services
RETROSPECTIVE studies
MANN Whitney U Test
DESCRIPTIVE statistics
TRACHEA intubation
LONGITUDINAL method
ODDS ratio
ALTERNATIVE medicine
MEDICAL records
ACQUISITION of data
AIRWAY (Anatomy)
COMPARATIVE studies
HEALTH outcome assessment
CONFIDENCE intervals
DATA analysis software
TRAUMA registries
GLOTTIS
Subjects
Details
- Language :
- English
- ISSN :
- 18639933
- Volume :
- 50
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- European Journal of Trauma & Emergency Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 180130931
- Full Text :
- https://doi.org/10.1007/s00068-024-02498-8