10.3389/fneur.2018.00194.s001
Rebecka Rubenson Wahlin
Rebecka Rubenson
Wahlin
David W. Nelson
David
W. Nelson
Bo-Michael Bellander
Bo-Michael
Bellander
Mikael Svensson
Mikael
Svensson
Adel Helmy
Adel
Helmy
Eric Peter Thelin
Eric
Peter Thelin
Table_1.docx
Frontiers
2018
traumatic brain injury
advanced airway management
prehospital trauma care
human
emergency medical services
2018-04-10 11:57:57
Dataset
https://frontiersin.figshare.com/articles/dataset/Table_1_docx/6121082
Background<p>Prehospital intubation in traumatic brain injury (TBI) focuses on limiting the effects of secondary insults such as hypoxia, but no indisputable evidence has been presented that it is beneficial for outcome. The aim of this study was to explore the characteristics of patients who undergo prehospital intubation and, in turn, if these parameters affect outcome.</p>Material and methods<p>Patients ≥15 years admitted to the Department of Neurosurgery, Stockholm, Sweden with TBI from 2008 through 2014 were included. Data were extracted from prehospital and hospital charts, including prospectively collected Glasgow Outcome Score (GOS) after 12 months. Univariate and multivariable logistic regression models were employed to examine parameters independently correlated to prehospital intubation and outcome.</p>Results<p>A total of 458 patients were included (n = 178 unconscious, among them, n = 61 intubated). Multivariable analyses indicated that high energy trauma, prehospital hypotension, pupil unresponsiveness, mode of transportation, and distance to the hospital were independently correlated with intubation, and among them, only pupil responsiveness was independently associated with outcome. Prehospital intubation did not add independent information in a step-up model versus GOS (p = 0.154). Prehospital reports revealed that hypoxia was not the primary cause of prehospital intubation, and that the procedure did not improve oxygen saturation during transport, while an increasing distance from the hospital increased the intubation frequency.</p>Conclusion<p>In this modern trauma cohort, prehospital intubation was not independently associated with outcome; however, hypoxia was not a common reason for prehospital intubation. Prospective trials to assess efficacy of prehospital airway intubation will be difficult due to logistical and ethical considerations.</p>