Williamson County EMS, Georgetown, TX, United States; Baylor Scott & White Healthcare, Temple, TX, United States.
Department of Emergency Health Science, The University of Texas Health Science Center, San Antonio, TX, United States.
Resuscitation. 2019 Aug;141:136-143. doi: 10.1016/j.resuscitation.2019.06.002. Epub 2019 Jun 22.
First pass advanced airway insertion success is associated with fewer adverse events. We sought to compare out-of-hospital endotracheal intubation (ETI) and supraglottic airway (SGA) first-pass success (FPS) rates between adults and children in a national cohort of EMS agencies.
We analyzed data from 2017 using a national cohort of 731 EMS agencies. Using multivariable logistic regression, we compared the odds of ETI and SGA FPS between adult (age >14 years) and pediatric (age ≤14 years) patients, adjusting for gender, ethnicity, indication, and drug facilitation. We performed a sensitivity analysis of all patients using age as a continuous variable for both ETI and SGA FPS. Finally, we calculated the odds of FPS using all possible age break points between 10 and 18 years old.
A total of 29,368 patients (28,846 adults and 522 children) received ETI (22,519) or SGA (6849). ETI FPS was higher in adults than children; 72.7% vs, 58.5%, (OR 1.80, 95% CI 1.49-2.17). SGA FPS was similar between adults and children; 89.8% vs 84.6%, (OR 1.63, CI 0.70-3.31). When analyzed as a continuous variable, ETI FPS remained associated with age in years: OR 1.007 (CI 1.006-1.009) and SGA FPS showed no significant association with age: OR 0.999 (0.995-1.004). The OR for ETI FPS were higher in adults than pediatrics at all potential age break points between 10 and 18 years old. The OR for SGA FPS was significantly more likely in adults than pediatrics using 16 as a break point but not significantly different between adults and pediatrics using any other age break point.
In this national cohort of out-of-hospital patients, ETI FPS was higher for adults than children. SGA FPS did not significantly vary with age. SGA FPS was higher than ETI FPS at all ages.
首次通过高级气道插入术的成功率与不良事件的发生较少相关。我们试图在全国范围内的 EMS 机构的队列中比较成人和儿童的院外气管插管（ETI）和喉上气道（SGA）首次通过成功率（FPS）。
我们使用全国范围内的 731 个 EMS 机构的队列，分析了 2017 年的数据。使用多变量逻辑回归，我们比较了成人（年龄＞14 岁）和儿科（年龄≤14 岁）患者的 ETI 和 SGA FPS 的可能性，调整了性别、种族、适应症和药物辅助。我们对所有患者进行了 ETI 和 SGA FPS 的年龄连续变量的敏感性分析。最后，我们使用年龄作为 10 到 18 岁之间的所有可能年龄断点来计算 FPS 的可能性。
共有 29368 名患者（28846 名成人和 522 名儿童）接受了 ETI（22519 名）或 SGA（6849 名）。成人的 ETI FPS 高于儿童；72.7%比 58.5%，（OR 1.80，95%CI 1.49-2.17）。成人和儿童的 SGA FPS 相似；89.8%比 84.6%，（OR 1.63，CI 0.70-3.31）。当作为连续变量进行分析时，ETI FPS 仍然与年龄相关：OR 1.007（CI 1.006-1.009），而 SGA FPS 与年龄无显著关联：OR 0.999（0.995-1.004）。成人在 10 到 18 岁之间的所有潜在年龄断点的 ETI FPS 可能性都高于儿科。在 16 岁作为分界点时，成人的 SGA FPS 明显高于儿科，但在使用任何其他年龄分界点时，成人和儿科之间没有显著差异。
在本项全国范围内的院外患者队列中，成人的 ETI FPS 高于儿童。SGA FPS 与年龄无显著差异。SGA FPS 在所有年龄段都高于 ETI FPS。
