Tracheal intubation in traumatic brain injury: a multicentre prospective observational study
07 марта 2021 года
05:46
Tracheal intubation in traumatic brain injury: a multicentre prospective observational study
Текст новости:
Title: Tracheal intubation in traumatic brain injury: a multicentre prospective observational study
Author, co-author: Gravesteijn, B. Y.; Sewalt, C. A.; Nieboer, D.; Menon, D. K.; Maas, A.; Lecky, F.; Klimek, M.; Lingsma, H. F.; Åkerlund, C.; Amrein, K.; Andelic, N.; Andreassen, L.; Anke, A.; Antoni, A.; Audibert, G.; Azouvi, P.; Azzolini, M. L.; Bartels, R.; Barzó, P.; Beauvais, R.; Beer, R.; Bellander, B.-M.; Belli, A.; Benali, H.; Berardino, M.; Beretta, L.; Blaabjerg, M.; Bragge, P.; Brazinova, A.; Brinck, V.; Brooker, J.; Brorsson, C.; Buki, A.; Bullinger, M.; Cabeleira, M.; Caccioppola, A.; Calappi, E.; Calvi, M. R.; Cameron, P.; Lozano, G. C.; Carbonara, M.; Cavallo, S.; Chevallard, G.; Chieregato, A.; Citerio, G.; Ceyisakar, I.; Clusmann, H.; Coburn, M.; Coles, J.; Cooper, J. D.; Correia, M.; Čović, A.; Curry, N.; Czeiter, E.; Czosnyka, M.; Dahyot-Fizelier, C.; Dark, P.; Dawes, H.; De Keyser, Véronique; Degos, V.; Della Corte, F.; Boogert, H. D.; Depreitere, B.; Đilvesi, Đ.; Dixit, A.; Donoghue, E.; Dreier, J.; Dulière, G.-L.; Ercole, A.; Esser, P.; Ezer, E.; Fabricius, M.; Feigin, V. L.; Foks, K.; Frisvold, S.; Furmanov, A.; Gagliardo, P.; Galanaud, D.; Gantner, D.; Gao, G.; George, P; Ghuysen, Alexandre; Giga, L.; Glocker, B.; Golubovic, J.; Gomez, P. A.; Gratz, J.; Gravesteijn, B.; Grossi, F.; Gruen, R. L.; Gupta, D.; Haagsma, J. A.; Haitsma, I.; Helbok, R.; Helseth, E.; Horton, L.; Huijben, J.; Hutchinson, P. J.; Jacobs, B.; Jankowski, S.; Jarrett, M.; Jiang, J.-Y.; Johnson, F.; Jones, K.; Karan, M.; Kolias, A. G.; Kompanje, E.; Kondziella, D.; Koraropoulos, E.; Koskinen, L.-O.; Kovács, N.; Kowark, A.; Lagares, A.; Lanyon, L.; Laureys, Steven; Ledoux, Didier; Lefering, R.; Legrand, Victor; Lejeune, André; Levi, L.; Lightfoot, R.; Lingsma, H.; Maas, A. I. R.; Castaño-León, A. M.; Maegele, M.; Majdan, M.; Manara, A.; Manley, G.; Martino, C.; Maréchal, H.; Mattern, J.; McMahon, C.; Melegh, B.; Menon, D.; Menovsky, T.; Mikolic, A.; Misset, Benoît; Muraleedharan, V.; Murray, L.; Negru, A.; Nelson, D.; Newcombe, V.; Nyirádi, J.; Olubukola, O.; Oresic, M.; Ortolano, F.; Palotie, A.; Parizel, P. M.; Payen, J.-F.; Perera, N.; Perlbarg, V.; Persona, P.; Peul, W.; Piippo-Karjalainen, A.; Pirinen, M.; Ples, H.; Polinder, S.; Pomposo, I.; Posti, J. P.; Puybasset, L.; Radoi, A.; Ragauskas, A.; Raj, R.; Rambadagalla, M.; Rhodes, J.; Richardson, S.; Richter, S.; Ripatti, S.; Rocka, S.; Roe, C.; Roise, O.; Rosand, J.; Rosenfeld, J. V.; Rosenlund, C.; Rosenthal, G.; Rossaint, R.; Rossi, S.; Rueckert, D.; Rusnák, M.; Sahuquillo, J.; Sakowitz, O.; Sanchez-Porras, R.; Sandor, J.; Schäfer, N.; Schmidt, S.; Schoechl, H.; Schoonman, G.; Schou, R. F.; Schwendenwein, E.; Sewalt, C.; Skandsen, T.; Smielewski, P.; Sorinola, A.; Stamatakis, E.; Stanworth, S.; Stevens, R.; Stewart, W.; Steyerberg, E. W.; Stocchetti, N.; Sundström, N.; Synnot, A.; Takala, R.; Tamás, V.; Tamosuitis, T.; Taylor, M. S.; Ao, B. T.; Tenovuo, O.; Theadom, A.; Thomas, M.; Tibboel, D.; Timmers, M.; Tolias, C.; Trapani, T.; Tudora, C. M.; Vajkoczy, P.; Vallance, S.; Valeinis, E.; Vámos, Z.; van der Jagt, M.; Van der Steen, G.; van der Naalt, J.; van Dijck, J. T. J. M.; van Essen, T. A.; Van Hecke, W.; van Heugten, C.; Van Praag, D.; Vyvere, T. V.; van Wijk, R. P. J.; Vargiolu, A.; Vega, E.; Velt, K.; Verheyden, J.; Vespa, P. M.; Vik, A.; Vilcinis, R.; Volovici, V.; von Steinbüchel, N.; Voormolen, D.; Vulekovic, P.; Wang, K. K. W.; Wiegers, E.; Williams, G.; Wilson, L.; Winzeck, S.; Wolf, S.; Yang, Z.; Ylén, P.; Younsi, A.; Zeiler, F. A.; Zelinkova, V.; Ziverte, A.; Zoerle, T.
Abstract: Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79–1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65–1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting. Clinical trial registration: NCT02210221. © 2020 The Author(s)

Связанные объекты: #A (найти в новостях), #Vega (найти в новостях), #Glasgow (найти в новостях).

Текст со страницы (автоматическое получение):
Tracheal intubation in traumatic brain injury: a multicentre prospective observational study
Language :
[Emergency Medicine Research in Sheffield (EMRiS), School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom, Centre for Urgent and Emergency Care Research (CURE), Health Services Research Section, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom, Emergency Department, Salford Royal Hospital, Salford, United Kingdom]
[Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland, Analytic and Translational Genetics Unit, Department of Medicine, Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States, Program in Medical and Population Genetics, The Stanley Center for Psychiatric Research, The Broad Institute of MIT and Harvard, Cambridge, MA, United States]
[Australian & New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia, Cochrane Consumers and Communication Review Group, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia]
Publication date :
Abstract :
[en] Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79–1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65–1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting. Clinical trial registration: NCT02210221. © 2020 The Author(s)
Research centres :
Permalink :
Автоматическая система мониторинга и отбора информации
Источник
Другие материалы рубрики
★★★★  06 марта 2021 года
22:27
Brain stereotactic radiotherapy damages recorded by Functional MRI
★★★  06 марта 2021 года
17:50
Aspects récents des mécanismes neuroendocriniens de la puberté
★★★★  06 марта 2021 года
09:10
Cannabis Consommation Marchandisation Echange d’information
★★  06 марта 2021 года
05:45
A new nucleosomic-based model to identify and diagnose SSc-ILD