Intubation first-pass success in a high performing pre-hospital critical care system is not associated with 30-day mortality: a registry study of 4496 intubation attempts

Lower intubation first-pass success (FPS) rate is associated with physiological deterioration, and FPS is widely used as a quality indicator of the airway management of a critically ill patient. However, data on FPS's association with survival is limited. We aimed to investigate if the FPS rate...

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Bibliographic Details
Published in:Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2022-11, Vol.30 (1), p.61-61, Article 61
Main Authors: Ljungqvist, Harry, Pirneskoski, Jussi, Saviluoto, Anssi, Setälä, Piritta, Tommila, Miretta, Nurmi, Jouni
Format: Article
Language:English
Subjects:
Air ambulances
Airway Management
Anesthesia
Blood pressure
Coma
Critical Care
Critical care medicine
Data collection
Emergency medical care
Emergency medical services
Emergency medicine
Emergency services
First-pass success
Heart rate
Hospitals
Humans
Hypotension
Hypoxia
Intubation
Intubation, Intratracheal
Methods
Missing data
Mortality
Original Research
Oxygen saturation
Paramedics
Patient outcomes
Patients
Quality management
Rapid sequence induction and intubation
Registries
Regression analysis
Success
Trachea
Vital signs
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Summary:Lower intubation first-pass success (FPS) rate is associated with physiological deterioration, and FPS is widely used as a quality indicator of the airway management of a critically ill patient. However, data on FPS's association with survival is limited. We aimed to investigate if the FPS rate is associated with 30-day mortality or physiological complications in a pre-hospital setting. Furthermore, we wanted to describe the FPS rate in Finnish helicopter emergency medical services. This was a retrospective observational study. Data on drug-facilitated intubation attempts by helicopter emergency medical services were gathered from a national database and analysed. Multivariate logistic regression, including known prognostic factors, was performed to assess the association between FPS and 30-day mortality, collected from population registry data. Of 4496 intubation attempts, 4082 (91%) succeeded on the first attempt. The mortality rates in FPS and non-FPS patients were 34% and 38% (P = 0.21), respectively. The adjusted odds ratio of FPS for 30-day mortality was 0.88 (95% CI 0.66-1.16). Hypoxia after intubation and at the time of handover was more frequent in the non-FPS group (12% vs. 5%, P 
ISSN:1757-7241
1757-7241
DOI:10.1186/s13049-022-01049-7