Hypoxemia Index Associated with Prehospital Intubation in COVID-19 Patients.
COVID-19
association
hypoxemia
index
intubation
prehospital
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
20 Sep 2020
20 Sep 2020
Historique:
received:
25
07
2020
revised:
11
09
2020
accepted:
15
09
2020
entrez:
23
9
2020
pubmed:
24
9
2020
medline:
24
9
2020
Statut:
epublish
Résumé
There exists a need for prognostic tools for the early identification of COVID-19 patients requiring prehospital intubation. Here we investigated the association between a prehospital Hypoxemia Index (HI) and the need for intubation among COVID-19 patients in the prehospital setting. We retrospectively analyzed COVID-19 patients initially cared for by a Paris Fire Brigade advanced life support (ALS) team in the prehospital setting between 8th March and 18th April of 2020. We assessed the association between HI and prehospital intubation using receiver operating characteristic (ROC) curve analysis and logistic regression model analysis after propensity score matching. Results are expressed as odds ratio (OR) and 95% confidence interval (CI). We analyzed 300 consecutive COVID-19 patients (166 males (55%); mean age, 64 ± 18 years). Among these patients, 45 (15%) were deceased on the scene, 34 (11%) had an active care restriction, and 18 (6%) were intubated in the prehospital setting. The mean HI value was 3.4 ± 1.9. HI was significantly associated with prehospital intubation (OR, 0.24; 95% CI: 0.12-0.41, An HI of <1.3 was associated with a 3-fold increase in prehospital intubation among COVID-19 patients. HI may be a useful tool to facilitate decision-making regarding prehospital intubation of COVID-19 patients initially cared for by a Paris Fire Brigade ALS team. Further prospective studies are needed to confirm these preliminary results.
Sections du résumé
BACKGROUND
BACKGROUND
There exists a need for prognostic tools for the early identification of COVID-19 patients requiring prehospital intubation. Here we investigated the association between a prehospital Hypoxemia Index (HI) and the need for intubation among COVID-19 patients in the prehospital setting.
METHODS
METHODS
We retrospectively analyzed COVID-19 patients initially cared for by a Paris Fire Brigade advanced life support (ALS) team in the prehospital setting between 8th March and 18th April of 2020. We assessed the association between HI and prehospital intubation using receiver operating characteristic (ROC) curve analysis and logistic regression model analysis after propensity score matching. Results are expressed as odds ratio (OR) and 95% confidence interval (CI).
RESULTS
RESULTS
We analyzed 300 consecutive COVID-19 patients (166 males (55%); mean age, 64 ± 18 years). Among these patients, 45 (15%) were deceased on the scene, 34 (11%) had an active care restriction, and 18 (6%) were intubated in the prehospital setting. The mean HI value was 3.4 ± 1.9. HI was significantly associated with prehospital intubation (OR, 0.24; 95% CI: 0.12-0.41,
CONCLUSION
CONCLUSIONS
An HI of <1.3 was associated with a 3-fold increase in prehospital intubation among COVID-19 patients. HI may be a useful tool to facilitate decision-making regarding prehospital intubation of COVID-19 patients initially cared for by a Paris Fire Brigade ALS team. Further prospective studies are needed to confirm these preliminary results.
Identifiants
pubmed: 32962227
pii: jcm9093025
doi: 10.3390/jcm9093025
pmc: PMC7563105
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
J Travel Med. 2020 Mar 13;27(2):
pubmed: 31985790
Lancet Respir Med. 2020 May;8(5):433-434
pubmed: 32203709
Ann Emerg Med. 2005 Apr;45(4):448-51
pubmed: 15795729
Clin Chest Med. 1994 Mar;15(1):1-12
pubmed: 8200186
Anaesthesia. 2020 Nov;75(11):1437-1447
pubmed: 32516833
Resuscitation. 2014 Dec;85(12):1720-5
pubmed: 25281907
Lancet Respir Med. 2020 Apr;8(4):e18
pubmed: 32145829
J Can Acad Child Adolesc Psychiatry. 2006 Aug;15(3):126-34
pubmed: 18392182
Anesth Analg. 2020 Aug;131(2):e128-e130
pubmed: 32404591
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
Int J Mol Sci. 2020 Apr 10;21(7):
pubmed: 32290293
JAMA. 2020 Apr 7;323(13):1239-1242
pubmed: 32091533
Clin Infect Dis. 2020 Jul 28;71(15):896-897
pubmed: 32271368
Crit Care Med. 2018 Apr;46(4):532-539
pubmed: 29261566
JAMA Pediatr. 2020 Apr 8;:
pubmed: 32267485
Intensive Care Med. 2020 May;46(5):854-887
pubmed: 32222812
West J Emerg Med. 2013 Mar;14(2):168-74
pubmed: 23599863
BMC Health Serv Res. 2020 Feb 12;20(1):110
pubmed: 32050947
Anaesthesia. 2020 Jun;75(6):785-799
pubmed: 32221970
Lancet Infect Dis. 2020 Jul;20(7):776-777
pubmed: 32224313
Stat Med. 2009 Nov 10;28(25):3083-107
pubmed: 19757444
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
J Med Virol. 2020 Apr;92(4):401-402
pubmed: 31950516
Respiration. 2020;99(8):667-677
pubmed: 32756065
J Med Virol. 2020 Jun;92(6):546-547
pubmed: 32115732
Eur J Emerg Med. 2020 Oct;27(5):327-328
pubmed: 32332201
Lancet Infect Dis. 2020 Jun;20(6):669-677
pubmed: 32240634
Health Technol Assess. 2015 Jun;19(42):v-vi, 1-102
pubmed: 26102313
Lancet Respir Med. 2020 Apr;8(4):e19
pubmed: 32105633
J Travel Med. 2020 Mar 13;27(2):
pubmed: 31943059
Respir Res. 2020 Jul 28;21(1):198
pubmed: 32723327
J Intensive Care Med. 2018 Mar;33(3):159-165
pubmed: 28486864
Eur Respir Rev. 2020 Apr 3;29(155):
pubmed: 32248146
Crit Care. 2020 Jun 8;24(1):313
pubmed: 32513249
Lancet Respir Med. 2020 Jun;8(6):538-539
pubmed: 32278367
J Autoimmun. 2020 May;109:102433
pubmed: 32113704
Multivariate Behav Res. 2011 May;46(3):399-424
pubmed: 21818162
Resuscitation. 2004 Oct;63(1):7-9
pubmed: 15451580
Br J Anaesth. 2018 Feb;120(2):323-352
pubmed: 29406182
JAMA. 2020 May 12;323(18):1775-1776
pubmed: 32203977
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):232-239
pubmed: 32391670
J Trauma Acute Care Surg. 2020 May;88(5):704-709
pubmed: 32320177
Obesity (Silver Spring). 2020 Jul;28(7):1195-1199
pubmed: 32271993
MMWR Morb Mortal Wkly Rep. 2020 Apr 17;69(15):472-476
pubmed: 32298249
N Engl J Med. 2020 Jun 11;382(24):2282-2284
pubmed: 32289216
PLoS One. 2012;7(4):e35797
pubmed: 22563403
BMJ. 2020 Apr 20;369:m1461
pubmed: 32312715
Eur Respir J. 2017 Aug 31;50(2):
pubmed: 28860265