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Western Journal of Emergency Medicine
University of California, Irvine
ISSN: 1936-9018

Volume 9, Issue 4 2008

Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury
Kurt R. Denninghoff MD, University of Arizona, Department of Emergency Medicine
Mervin J. Griffin MD, University of Alabama Birmingham and Injury Control Research Center
Alfred A. Bartolucci PhD, University of Alabama Birmingham School of Public Health and Injury Control Research Center
Steven G. LoBello PhD, MSPH, Auburn University Montgomery and Injury Control Research Center
Philip R. Fine PhD, University of Alabama Birmingham Injury Control Research Center and School of Public Health

Download the Paper (PDF format) - November 14, 2008 Tell a colleague about it.
Printing Tips: Select 'print as image' in the Acrobat print dialog if you have trouble printing. This work has been peer reviewed.

ABSTRACT:

Objective: To determine the relationship between emergent intubation (emergency department and field intubation cases combined) and mortality in patients with traumatic brain injury (TBI) 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. [WestJEM.2008;9:184-189]

KEYWORDS:
Intubation, Brain Injury, Emergency, Injury, Trauma, Mortality

SUGGESTED CITATION:
Kurt R. Denninghoff MD; Mervin J. Griffin MD; Alfred A. Bartolucci PhD; Steven G. LoBello PhD, MSPH; and Philip R. Fine PhD (2008) "Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury", Western Journal of Emergency Medicine: Vol. 9: No. 4, Article 1.
http://repositories.cdlib.org/uciem/westjem/vol9/iss4/art1




 
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