[Effect of intubation timing on the clinical course of polytrauma patients with lung contusions].
Aim of the study was to evaluate the influence of early intubation at the scene on the outcome of polytraumatized patients with lung-contusion.


METHODS
377 patients with lung-contusion out of 1031 polytraumatized patients were evaluated in this study. Patients, intubated at the scene were compared with those, who were intubated later. We compared the in-hospital time, the time at the ICU, the pneumonia-rate and the ARDS-rate. Age and injury severity of the compared groups were comparable.


RESULTS
In-hospital time and time at the ICU were shorter in the early intubated group than in the later intubated (in-hospital time 34.5 d and 39.4 d, time at the ICU 19.9 d and 23.7 d, resp.). For the time at the ICU the difference is significant. Also a reduction was found in the pneumoniarates (23.7% and 13.2%). The ARDS rate was reduced, too, but both differences were not significant (ppneumonia = 0.053, pARDS = 0.117). The mortality also was not significantly reduced (23.4% and 22.7%, resp.).


CONCLUSIONS
Early intubation at the scene can reduce the inhospital-time, the time at the ICU and the complications. In this way it becomes an important factor of cost-reduction. Therefore early intubation at the scene must become a standard for all patients with lung-contusion.
Huf
R
R
Chirurgische Klinik und Poliklinik, Universität München.
Kraft
S
S
Schildberg
F W
FW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003288:Contusions / Q000401:mortality / Q000628:therapy*; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007442:Intubation, Intratracheal; D007902:Length of Stay / Q000706:statistics & numerical data*; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality / Q000628:therapy*; D011014:Pneumonia / Q000401:mortality / Q000517:prevention & control*; D011175:Positive-Pressure Respiration; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000517:prevention & control*; D015996:Survival Rate; D016896:Treatment Outcome