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Critical Care Research and Practice
Volume 2014, Article ID 135986, 6 pages
http://dx.doi.org/10.1155/2014/135986
Clinical Study

Prehospital Intubation in Patients with Isolated Severe Traumatic Brain Injury: A 4-Year Observational Study

1Department of Surgery, Section of Trauma Surgery, Hamad General Hospital (HGH), P.O. Box 3050, Doha, Qatar
2Clinical Research, Section of Trauma Surgery, HGH, P.O. Box 3050, Doha, Qatar
3Clinical Medicine, Weill Cornell Medical School, P.O. Box 24144, Doha, Qatar
4Department of Surgery, University of Arizona, P.O. Box 245005, Tucson, AZ, USA

Received 3 August 2013; Revised 8 October 2013; Accepted 19 October 2013; Published 16 January 2014

Academic Editor: Peter J. Papadakos

Copyright © 2014 Mazin Tuma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To study the effect of prehospital intubation (PHI) on survival of patients with isolated severe traumatic brain injury (ISTBI). Method. Retrospective analyses of all intubated patients with ISTBI between 2008 and 2011 were studied. Comparison was made between those who were intubated in the PHI versus in the trauma resuscitation unit (TRU). Results. Among 1665 TBI patients, 160 met the inclusion criteria (105 underwent PHI, and 55 patients were intubated in TRU). PHI group was younger in age and had lower median scene motor GCS (). Ventilator days and hospital length of stay ( and 0.006, resp.) were higher in TRUI group. Mean ISS, length of stay, initial blood pressure, pneumonia, and ARDS were comparable among the two groups. Mortality rate was higher in the PHI group (54% versus 31%, ). On multivariate regression analysis, scene motor GCS (OR 0.55; 95% CI 0.41–0.73) was an independent predictor for mortality. Conclusion. PHI did not offer survival benefit in our group of patients with ISTBI based on the head AIS and the scene motor GCS. However, more studies are warranted to prove this finding and identify patients who may benefit from this intervention.