A retrospective cohort study on association of age and physician decision making for or against rapid sequence intubation in unconscious patients.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
28 02 2022
28 02 2022
Historique:
received:
22
07
2021
accepted:
04
02
2022
entrez:
1
3
2022
pubmed:
2
3
2022
medline:
13
4
2022
Statut:
epublish
Résumé
In unconscious individuals, rapid sequence intubation (RSI) may be necessary for cardiopulmonary stabilisation and avoidance of secondary damage. Opinions on such invasive procedures in people of older age vary. We thus sought to evaluate a possible association between the probability of receiving prehospital RSI in unconsciousness and increasing age. We conducted a retrospective study in all missions (traumatic and non-traumatic) of the prehospital emergency physician response unit in Graz between January 1st, 2010 and December 31st, 2019, which we searched for Glasgow Coma Scale (GCS) below 9. Cardiac arrests were excluded. We performed multivariable regression analysis for RSI with age, GCS, independent living, and suspected cause as independent variables. Of the 769 finally included patients, 256 (33%) received RSI, whereas 513 (67%) did not. Unadjusted rates of RSI were significantly lower in older patients (aged 85 years and older) compared to the reference group aged 50-64 years (13% vs. 51%, p < 0.001). In multivariable regression analysis, patients aged 85 years and older were also significantly less likely to receive RSI [OR (95% CI) 0.76 (0.69-0.84)]. We conclude that advanced age, especially 85 years or older, is associated with significantly lower odds of receiving prehospital RSI in cases of unconsciousness.
Identifiants
pubmed: 35228569
doi: 10.1038/s41598-022-06787-3
pii: 10.1038/s41598-022-06787-3
pmc: PMC8885918
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3336Informations de copyright
© 2022. The Author(s).
Références
Sci Rep. 2020 Aug 4;10(1):13161
pubmed: 32753615
BMC Health Serv Res. 2014 Sep 10;14:380
pubmed: 25209450
J Stroke Cerebrovasc Dis. 2020 May;29(5):104695
pubmed: 32085939
Ann Intern Med. 1999 Jan 19;130(2):116-25
pubmed: 10068357
Neurocrit Care. 2012 Sep;17 Suppl 1:S54-9
pubmed: 22932989
J Neurotrauma. 2011 Apr;28(4):527-34
pubmed: 21265592
Brain Inj. 2016;30(10):1194-200
pubmed: 27466967
Eur J Emerg Med. 2019 Oct;26(5):366-372
pubmed: 30308574
Am J Emerg Med. 2010 Sep;28(7):757-65
pubmed: 20837251
Eur J Emerg Med. 2016 Oct;23(5):375-80
pubmed: 26426739
Age Ageing. 2014 Nov;43(6):759-66
pubmed: 25315230
J Am Geriatr Soc. 2014 Nov;62(11):2088-94
pubmed: 25376084
J Am Med Dir Assoc. 2015 Nov 1;16(11):940-5
pubmed: 26255709
Ann Intensive Care. 2011 Aug 01;1(1):29
pubmed: 21906383
Emerg Med J. 2012 Nov;29(11):887-9
pubmed: 22036938
BMC Anesthesiol. 2015 Apr 29;15:65
pubmed: 25924678
Intensive Care Med. 2017 Aug;43(8):1105-1122
pubmed: 28676896
Lancet. 1974 Jul 13;2(7872):81-4
pubmed: 4136544
Clin Geriatr Med. 2011 Feb;27(1):1-15
pubmed: 21093718
World Neurosurg. 2016 Jun;90:525-529
pubmed: 26721615
Eur J Trauma Emerg Surg. 2018 Apr;44(Suppl 1):3-271
pubmed: 29654333
Crit Care Med. 2006 Oct;34(10):2583-7
pubmed: 16915114
Resuscitation. 2019 Aug;141:136-143
pubmed: 31238034
J Neurosurg Anesthesiol. 2017 Apr;29(2):161-167
pubmed: 26797107
J Clin Med. 2020 Jan 16;9(1):
pubmed: 31963162
Emerg Med J. 2004 May;21(3):296-301
pubmed: 15107366
Clin Med (Lond). 2018 Feb;18(1):88-92
pubmed: 29436445
Am J Med Qual. 1998 Fall;13(3):121-6
pubmed: 9735474
Crit Care Med. 1999 Nov;27(11):2351-7
pubmed: 10579247
Resuscitation. 2011 Jul;82(7):881-5
pubmed: 21440977
Scand J Trauma Resusc Emerg Med. 2016 Aug 24;24(1):103
pubmed: 27554262