title: Prehospital versus Emergency Room Intubation of Trauma Patients in Qatar: A-2-year Observational Study.
abstract: BACKGROUND
  The impact of prehospital intubation (PHI) in improving outcome of trauma patients has not been adequately evaluated in the developing countries.
  
  
  OBJECTIVE
  The present study analyzed the outcome of PHI versus emergency room intubation (ERI) among trauma patients in Qatar.
  
  
  METHODS
  Data were retrospectively reviewed for all intubated trauma patients between 2010 and 2011. Patients were classified according to location of intubation (PHI: Group-1 versus ERI: Group-2). Data were analyzed and compared.
  
  
  RESULTS
  Out of 570 intubated patients; 482 patients (239 in group-1 and 243 in group-2) met the inclusion criteria with a mean age of 32 ΁ 14.6 years Head injury (P = 0.003) and multiple trauma (P = 0.004) were more prevalent in group-1, whereas solid organ injury predominated in group-2 (P = 0.02). Group-1 had significantly higher mean injury severity scoring (ISS), lower Glasgow coma scale (GCS), greater head abbreviated injury score and longer activation, response, scene and total emergency medical services times. The mortality was higher in group-1 (53% vs. 18.5%; P = 0.001). Multivariate analysis showed that GCS [odds ratio (OR) 0.78, P = 0.005) and ISS (OR 1.12, P = 0.001) were independent predictors of mortality.
  
  
  CONCLUSIONS
  PHI is associated with high mortality when compared with ERI. However, selection bias cannot be ruled out and therefore, PHI needs further critical assessment in Qatar.
authors.affiliation: Department of Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
authors.affiliation: Clinical Research, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar ; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Department of Surgery, Hamad General Hospital, Doha, Qatar ; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar ; Department of Surgery, Arizona University, Tucson, Arizona, USA.
authors.forename: Rifat
authors.initials: R
authors.lastname: Latifi
keywords: Emergency room; intubation; mode of transport; on-scene; prehospital; trauma