Association of prehospital airway management technique with survival outcomes of out-of-hospital cardiac arrest patients
Despite numerous studies on airway management in out-of-hospital cardiac arrest (OHCA) patients, the choice of prehospital airway management technique remains controversial. Our study aimed to investigate the association between prehospital advanced airway management and survival outcomes according...
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| Veröffentlicht in: | PloS one 2022-06, Vol.17 (6), p.e0269599-e0269599 |
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| creator | Jung, Eujene Ro, Young Sun Ryu, Hyun Ho Shin, Sang Do |
| description | Despite numerous studies on airway management in out-of-hospital cardiac arrest (OHCA) patients, the choice of prehospital airway management technique remains controversial. Our study aimed to investigate the association between prehospital advanced airway management and survival outcomes according to a transport time interval (TTI) using nationwide OHCA registry database in Korea.
The inclusion criteria were patients with OHCA aged over 18 years old with a presumed cardiac etiology between January 2015 and December 2018. The primary outcome was survival to hospital discharge. The main exposure was the prehospital airway management technique performed by the emergency medical technicians (EMTs), classified as bag-valve mask (BVM), supraglottic airway (SGA), or endotracheal intubation (ETI).We performed multivariable logistic regression analysis and interaction analysis between the type of airway management and TTI for adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Of a total of 70,530 eligible OHCA patients, 26,547 (37.6%), 38,391 (54.4%), and 5,592 (7.9%) were managed with BVM, SGA, ETI, respectively. Patients in the SGA and ETI groups had a higher odds of survival to discharge than BVM groups (aOR, 1.11 (1.05-1.16) and 1.13 (1.05-1.23)). And the rates of survival to discharge with SGA and ETI were significantly higher in groups with TTI more than 8 minutes (1.17 (1.08-1.27) and 1.38 (1.20-1.59)).
The survival to discharge was significantly higher among patients who received ETI and SGA than in those who received BVM. The transport time interval influenced the effect of prehospital airway management on the clinical outcomes after OHCA. |
| doi_str_mv | 10.1371/journal.pone.0269599 |
| format | Article |
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The inclusion criteria were patients with OHCA aged over 18 years old with a presumed cardiac etiology between January 2015 and December 2018. The primary outcome was survival to hospital discharge. The main exposure was the prehospital airway management technique performed by the emergency medical technicians (EMTs), classified as bag-valve mask (BVM), supraglottic airway (SGA), or endotracheal intubation (ETI).We performed multivariable logistic regression analysis and interaction analysis between the type of airway management and TTI for adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Of a total of 70,530 eligible OHCA patients, 26,547 (37.6%), 38,391 (54.4%), and 5,592 (7.9%) were managed with BVM, SGA, ETI, respectively. Patients in the SGA and ETI groups had a higher odds of survival to discharge than BVM groups (aOR, 1.11 (1.05-1.16) and 1.13 (1.05-1.23)). And the rates of survival to discharge with SGA and ETI were significantly higher in groups with TTI more than 8 minutes (1.17 (1.08-1.27) and 1.38 (1.20-1.59)).
The survival to discharge was significantly higher among patients who received ETI and SGA than in those who received BVM. The transport time interval influenced the effect of prehospital airway management on the clinical outcomes after OHCA.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0269599</identifier><identifier>PMID: 35666760</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Airway management ; Ambulatory medical care ; Cardiac arrest ; Care and treatment ; Clinical outcomes ; Confidence intervals ; Emergency medical care ; Emergency medical services ; Emergency services ; Engineering and Technology ; Etiology ; Evaluation ; Fires ; Heart ; Hospitals ; Intubation ; Management ; Medical care ; Medical records ; Medicine and Health Sciences ; Patients ; People and Places ; Quality management ; Regression analysis ; Research and Analysis Methods ; Respiratory tract ; Review boards ; Statistical analysis ; Survival ; Technicians ; Ventilators</subject><ispartof>PloS one, 2022-06, Vol.17 (6), p.e0269599-e0269599</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Jung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Jung et al 2022 Jung et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-a116ca43c1804803e32cae33be1afe49e7ccc4259bd2f2dcc3316ff2ee1a79dd3</citedby><cites>FETCH-LOGICAL-c692t-a116ca43c1804803e32cae33be1afe49e7ccc4259bd2f2dcc3316ff2ee1a79dd3</cites><orcidid>0000-0002-0276-9994</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9170082/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9170082/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35666760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Eujene</creatorcontrib><creatorcontrib>Ro, Young Sun</creatorcontrib><creatorcontrib>Ryu, Hyun Ho</creatorcontrib><creatorcontrib>Shin, Sang Do</creatorcontrib><title>Association of prehospital airway management technique with survival outcomes of out-of-hospital cardiac arrest patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Despite numerous studies on airway management in out-of-hospital cardiac arrest (OHCA) patients, the choice of prehospital airway management technique remains controversial. Our study aimed to investigate the association between prehospital advanced airway management and survival outcomes according to a transport time interval (TTI) using nationwide OHCA registry database in Korea.
The inclusion criteria were patients with OHCA aged over 18 years old with a presumed cardiac etiology between January 2015 and December 2018. The primary outcome was survival to hospital discharge. The main exposure was the prehospital airway management technique performed by the emergency medical technicians (EMTs), classified as bag-valve mask (BVM), supraglottic airway (SGA), or endotracheal intubation (ETI).We performed multivariable logistic regression analysis and interaction analysis between the type of airway management and TTI for adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Of a total of 70,530 eligible OHCA patients, 26,547 (37.6%), 38,391 (54.4%), and 5,592 (7.9%) were managed with BVM, SGA, ETI, respectively. Patients in the SGA and ETI groups had a higher odds of survival to discharge than BVM groups (aOR, 1.11 (1.05-1.16) and 1.13 (1.05-1.23)). And the rates of survival to discharge with SGA and ETI were significantly higher in groups with TTI more than 8 minutes (1.17 (1.08-1.27) and 1.38 (1.20-1.59)).
The survival to discharge was significantly higher among patients who received ETI and SGA than in those who received BVM. The transport time interval influenced the effect of prehospital airway management on the clinical outcomes after OHCA.</description><subject>Airway management</subject><subject>Ambulatory medical care</subject><subject>Cardiac arrest</subject><subject>Care and treatment</subject><subject>Clinical outcomes</subject><subject>Confidence intervals</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency services</subject><subject>Engineering and Technology</subject><subject>Etiology</subject><subject>Evaluation</subject><subject>Fires</subject><subject>Heart</subject><subject>Hospitals</subject><subject>Intubation</subject><subject>Management</subject><subject>Medical care</subject><subject>Medical records</subject><subject>Medicine and Health Sciences</subject><subject>Patients</subject><subject>People and Places</subject><subject>Quality management</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Respiratory tract</subject><subject>Review boards</subject><subject>Statistical 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titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Eujene</au><au>Ro, Young Sun</au><au>Ryu, Hyun Ho</au><au>Shin, Sang Do</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of prehospital airway management technique with survival outcomes of out-of-hospital cardiac arrest patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2022-06-06</date><risdate>2022</risdate><volume>17</volume><issue>6</issue><spage>e0269599</spage><epage>e0269599</epage><pages>e0269599-e0269599</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Despite numerous studies on airway management in out-of-hospital cardiac arrest (OHCA) patients, the choice of prehospital airway management technique remains controversial. Our study aimed to investigate the association between prehospital advanced airway management and survival outcomes according to a transport time interval (TTI) using nationwide OHCA registry database in Korea.
The inclusion criteria were patients with OHCA aged over 18 years old with a presumed cardiac etiology between January 2015 and December 2018. The primary outcome was survival to hospital discharge. The main exposure was the prehospital airway management technique performed by the emergency medical technicians (EMTs), classified as bag-valve mask (BVM), supraglottic airway (SGA), or endotracheal intubation (ETI).We performed multivariable logistic regression analysis and interaction analysis between the type of airway management and TTI for adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Of a total of 70,530 eligible OHCA patients, 26,547 (37.6%), 38,391 (54.4%), and 5,592 (7.9%) were managed with BVM, SGA, ETI, respectively. Patients in the SGA and ETI groups had a higher odds of survival to discharge than BVM groups (aOR, 1.11 (1.05-1.16) and 1.13 (1.05-1.23)). And the rates of survival to discharge with SGA and ETI were significantly higher in groups with TTI more than 8 minutes (1.17 (1.08-1.27) and 1.38 (1.20-1.59)).
The survival to discharge was significantly higher among patients who received ETI and SGA than in those who received BVM. The transport time interval influenced the effect of prehospital airway management on the clinical outcomes after OHCA.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35666760</pmid><doi>10.1371/journal.pone.0269599</doi><tpages>e0269599</tpages><orcidid>https://orcid.org/0000-0002-0276-9994</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Airway management Ambulatory medical care Cardiac arrest Care and treatment Clinical outcomes Confidence intervals Emergency medical care Emergency medical services Emergency services Engineering and Technology Etiology Evaluation Fires Heart Hospitals Intubation Management Medical care Medical records Medicine and Health Sciences Patients People and Places Quality management Regression analysis Research and Analysis Methods Respiratory tract Review boards Statistical analysis Survival Technicians Ventilators |
| title | Association of prehospital airway management technique with survival outcomes of out-of-hospital cardiac arrest patients |
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