ABSTRACTS
Survival Outcomes Following Prehospital Intubation in Non-Traumatic Out-of-Hospital Cardiac Arrest: A Five-Year Retrospective Cohort Study in BangkokAuthor: Nichakarn Ruttanaporn | Doctor | Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University Associate Authors: Chaiyaporn Yuksen | Siriporn Damdin | Chetsadakon Jenpanitpong | Suteenun Seesuklom | Chantarat Palee
Introduction Out-of-hospital cardiac arrest (OHCA) is one of the most challenging medical emergencies in pre-hospital care. Airway management plays a crucial role in resuscitation, with endotracheal intubation (ETI) and bag-valve-mask ventilation (BVM) being the most common methods. Currently, there is no standardized protocol for airway management in non-traumatic OHCA established with inconclusive evidence. This study aims to demonstrate the superiority of endotracheal intubation in survival outcomes of non-traumatic OHCA. Methods This retrospective observational cohort study was conducted at the Emergency Medical Services (EMS) Center, Bangkok Metropolitan Administration, over 5 years, from January 2019 to December 2023. The records of non-traumatic OHCA adult patients who received EMS were analysed, including airway methods (ETI and BVM) received during resuscitation. The primary outcome was survival to emergency department admission, at scene and hospital discharge. Results Out of 13,633 patients with non-traumatic OHCA, 5,341 patients met the eligibility criteria. Among them, 2,482 (46.5%) received ETI, while 2,857 (53.5%) were managed with BVM ventilation. ETI was associated with a 22% increase in the likelihood of return of spontaneous circulation (ROSC) at the scene (95% CI: 0.19–0.25, P < 0.001), 6% increase in the likelihood of survival to hospital emergency department (ED) admission (95% CI: 0.05–0.08, P < 0.001) and 1% increase in the likelihood of survival to hospital discharge (95% CI: 0.00–0.02, P = 0.003). Conclusions In non-traumatic OHCA, the prehospital airway method of ETI has demonstrated superiority over BVM in survival outcomes, including survival to hospital department admission, ROSC at scene, and survival to hospital discharge. Keyword: out-of-hospital cardiac arrests, endotracheal intubation, airway management, Return of Spontaneous Circulation, Ventilation.
|
