Division of General Anaesthesiology, Emergency- and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
Sci Rep. 2022 Feb 28;12(1):3336. doi: 10.1038/s41598-022-06787-3.
In unconscious individuals, rapid sequence intubation (RSI) may be necessary for cardiopulmonary stabilisation and avoidance of secondary damage. Opinions on such invasive procedures in people of older age vary. We thus sought to evaluate a possible association between the probability of receiving prehospital RSI in unconsciousness and increasing age. We conducted a retrospective study in all missions (traumatic and non-traumatic) of the prehospital emergency physician response unit in Graz between January 1st, 2010 and December 31st, 2019, which we searched for Glasgow Coma Scale (GCS) below 9. Cardiac arrests were excluded. We performed multivariable regression analysis for RSI with age, GCS, independent living, and suspected cause as independent variables. Of the 769 finally included patients, 256 (33%) received RSI, whereas 513 (67%) did not. Unadjusted rates of RSI were significantly lower in older patients (aged 85 years and older) compared to the reference group aged 50-64 years (13% vs. 51%, p < 0.001). In multivariable regression analysis, patients aged 85 years and older were also significantly less likely to receive RSI [OR (95% CI) 0.76 (0.69-0.84)]. We conclude that advanced age, especially 85 years or older, is associated with significantly lower odds of receiving prehospital RSI in cases of unconsciousness.
在无意识的个体中，为了进行心肺稳定和避免继发损伤，可能需要进行快速序列插管（RSI）。对于老年人进行此类有创操作的意见存在差异。因此，我们试图评估无意识患者接受院前 RSI 的可能性与年龄增长之间的关联。我们对 2010 年 1 月 1 日至 2019 年 12 月 31 日期间格拉茨院前急救医生反应单位的所有任务（创伤性和非创伤性）进行了回顾性研究，我们在这些任务中寻找格拉斯哥昏迷量表（GCS）评分低于 9 分的病例。排除心脏骤停患者。我们将 RSI 与年龄、GCS、独立生活能力和疑似病因作为独立变量进行多变量回归分析。在最终纳入的 769 例患者中，有 256 例（33%）接受了 RSI，而 513 例（67%）未接受 RSI。与参考组（50-64 岁）相比，未调整的 RSI 发生率在年龄较大的患者（85 岁及以上）中明显较低（13%比 51%，p<0.001）。在多变量回归分析中，85 岁及以上的患者接受 RSI 的可能性也显著降低[OR（95%CI）0.76（0.69-0.84）]。我们得出结论，高龄，特别是 85 岁及以上，与无意识患者院前接受 RSI 的可能性显著降低相关。
