Observed versus expected mortality in pediatric patients intubated in the field with Glasgow Coma Scale scores < 9.
Abbreviated Injury Scale
Adolescent
Adult
Age Factors
Aged
Brain Injuries, Traumatic
/ mortality
Child
Child, Preschool
Emergency Medical Services
Female
Glasgow Coma Scale
Guidelines as Topic
Humans
Infant
Intubation, Intratracheal
/ mortality
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Trauma Centers
/ statistics & numerical data
Trauma Severity Indices
Treatment Outcome
Young Adult
Glasgow Coma Scale
Intubation
Pediatric
Prehospital
Traumatic brain injury
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
04
12
2017
accepted:
26
12
2018
pubmed:
12
1
2019
medline:
14
4
2020
entrez:
12
1
2019
Statut:
ppublish
Résumé
A Glasgow Coma Scale (GCS) score of 8 or less in patients suffering from severe traumatic brain injury (TBI) represents a decision-making marker in terms of intubation. This study evaluated the impact of prehospital intubation on the mortality of these TBI cases among different age groups. This study included the data from patients predominantly suffering from severe TBI [Abbreviated Injury Scale (AIS) of the head ≥ 3, GCS score < 9, Injury Severity Score (ISS) > 9] who were registered in TraumaRegister DGU A total of 21,242 patients were included. More often, the intubated patients were severely injured when compared to the non-intubated patients (median ISS 29, IQR 22-41 vs. 24, IQR 16-29, respectively), with an associated higher mortality (42.2% vs. 30.0%, respectively). When compared to the calculated expected mortality, the observed mortality was significantly higher among the intubated patients within the youngest subgroup (42.2% vs. 33.4%, respectively; p = 0.03). The observed mortality in the intubated children 1-6 years old suffering from severe TBI seemed to be higher than expected. Whether or not a GCS score of 8 or less is the only reliable criterion for intubation in this age group should be investigated in further trials.
Identifiants
pubmed: 30631886
doi: 10.1007/s00068-018-01065-2
pii: 10.1007/s00068-018-01065-2
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
769-776Commentaires et corrections
Type : CommentIn
Références
Curr Opin Crit Care. 2008 Apr;14(2):142-8
pubmed: 18388675
Curr Opin Anaesthesiol. 2012 Oct;25(5):556-62
pubmed: 22821147
Prehosp Disaster Med. 2014 Feb;29(1):32-6
pubmed: 24330753
JAMA. 2000 Feb 9;283(6):783-90
pubmed: 10683058
Ann Surg. 2010 Dec;252(6):959-65
pubmed: 21107105
Injury. 2017 Jan;48(1):32-40
pubmed: 27586065
PLoS One. 2015 Oct 23;10(10):e0141034
pubmed: 26496440
J Trauma Acute Care Surg. 2015 Dec;79(6):983-9; discussion 989-90
pubmed: 26680137
Br J Anaesth. 2009 Sep;103(3):371-86
pubmed: 19648153
J Trauma. 2010 Aug;69(2):294-301
pubmed: 20699737
Crit Care. 2014 Sep 05;18(5):476
pubmed: 25394596
Eur J Trauma Emerg Surg. 2017 Dec;43(6):731-739
pubmed: 27567923
CMAJ. 2008 Apr 22;178(9):1171-3
pubmed: 18427092
Ann Emerg Med. 2004 Nov;44(5):439-50
pubmed: 15520702
J Neurosurg Anesthesiol. 2017 Apr;29(2):161-167
pubmed: 26797107
Semin Pediatr Surg. 2001 Feb;10(1):3-6
pubmed: 11172563
Eur J Med Res. 2015 Aug 14;20:65
pubmed: 26272597
J Neurotrauma. 2010 Jul;27(7):1233-41
pubmed: 20373856
J Trauma. 2011 Oct;71(4):826-32
pubmed: 21427618
Emerg Med J. 2015 Nov;32(11):869-75
pubmed: 25795741
Br J Anaesth. 2002 Mar;88(3):345-9
pubmed: 11990264
J Trauma. 2004 Mar;56(3):492-9; discussion 499-500
pubmed: 15128118
Chin J Traumatol. 2015;18(3):125-34
pubmed: 26643236
Am J Emerg Med. 1989 Jul;7(4):364-6
pubmed: 2735981
Eur J Emerg Med. 2014 Dec;21(6):418-23
pubmed: 24368407