Document Detail


Prehospital intubation in patients with severe head injury.
MedLine Citation:
PMID:  11130490     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prehospital intubation and airway control is routinely performed by paramedics in critically injured patients. Despite the advantages provided by this procedure, numerous potential risks exist when this is performed in the field. We reviewed the outcome of patients with severe head injury, to determine whether prehospital intubation is associated with an improved outcome. METHODS: A retrospective review of registry data of patients admitted to an urban trauma center with severe head injury (field Glasgow Coma Scale score of < or =8 and head Abbreviated Injury Scale score of > or =3) was performed. Patients were stratified by methods of airway control performed by prehospital personnel: not intubated, intubated, or unsuccessful intubation. Mortality was determined for each group. To control for significant variables between these populations, matching and multivariate analysis were performed. RESULTS: Patients requiring prehospital intubation or in whom intubation was attempted had an increased mortality (81% and 77%, respectively) when compared with nonintubated patients (43%). The mortality for patients who had prehospital intubation performed did not demonstrate an improved survival using matching. In fact, intubated patients had a significantly higher relative risk (RR) of mortality when compared with nonintubation (RR = 1.74,p < 0.001) and unsuccessful intubation patients (RR = 1.53, p = 0.008) CONCLUSION: For patients with severe head injury, prehospital intubation did not demonstrate an improvement in survival. Further prospective randomized trials are necessary to confirm these results.
Authors:
J A Murray; D Demetriades; T V Berne; S J Stratton; H G Cryer; F Bongard; A Fleming; D Gaspard
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  49     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-20     Completed Date:  2001-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1065-70     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Los Angeles County, University of Southern California Medical Center, Los Angeles County Department of Health Services, 90033, USA. jamurray@hsc.usc.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Craniocerebral Trauma / mortality*,  therapy*
Emergency Treatment / statistics & numerical data*
Female
Glasgow Coma Scale
Humans
Injury Severity Score
Intubation, Intratracheal*
Logistic Models
Los Angeles / epidemiology
Male
Outcome Assessment (Health Care)*
Registries
Retrospective Studies
Risk Factors
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  An evidence-based cost-effectiveness model on methods of prevention of posttraumatic venous thromboe...
Next Document:  Outcome of patients with diffuse axonal injury: the significance and prognostic value of MRI in the ...