Impact of intervention time on hospital survival in patients requiring emergent airway management: a preliminary study
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The time in the day of intervention for physiological deterioration reportedly impacts patient outcomes. This study aimed at determining the impact of the time of ETI on hospital survival in critically ill patients.
Between January 2014 and December 2016, 151 patients who underwent emergency tracheal intubation (ETI) by the airway response team (ART) in the general wards of a tertiary referral center were retrospectively reviewed. Patients were divided into two groups based on the time of ETI (daytime group, 8:00 a.m.–4:00 p.m., n = 57, mean age 63.5 ± 14.1 years; nighttime group, 4:00 p.m.–8:00 a.m., n = 94, mean age 60.4 ± 14.9 years). Data regarding demographic information, comorbidities, trigger events for intubation, survival-to-discharge rates, acute physiology and chronic health evaluation II (APACHE II), ventilator-free days, and airway techniques were collected.
There was no significant difference in sex, age, body mass index, APACHE II, or comorbidities between the two groups, except that a higher proportion of patients presented with arrhythmias (21.1 vs. 8.5%, p = 0.028) and received fiberoptic intubation (24.6 vs. 11.7%, p = 0.039) in the daytime group than in the nighttime group. The time of the ART arrival after call was also shorter in daytime than that in nighttime (6.1 ± 1.4 vs. 10.5 ± 3.2 min, respectively, p < 0.001). There were no differences in the survival-to-discharge rate (45.6 vs. 43.6%, p = 0.811), ventilator-free days, or trigger events between the two groups.
Emergent tracheal intubation in the nighttime may not have negative impact on the survival-to-discharge rate compared with that performed in the daytime.
KeywordsTracheal intubation Hospital survival Airway response team
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The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.
- 6.Saleem MA, Kannam H, Aronow WS, Weiss MB, Kalapatapu K, Pucillo AL, Monsen CE. The effects of off-normal hours, age, and gender for coronary angioplasty on hospital mortality in patients undergoing coronary angioplasty for acute myocardial infarction. Am J Cardiol. 2004;93:763–4.CrossRefPubMedGoogle Scholar
- 11.Muller JE, Stone PH, Turi ZG, Rutherford JD, Czeisler CA, Parker C, Poole WK, Passamani E, Roberts R, Robertson T, Sobel BE, Willerson JT, Braunwald E, MILIS Study Group. Circadian variation in the frequency of onset of acute myocardial infarction. N Engl J Med. 1985;313:1315–22.CrossRefPubMedGoogle Scholar