title: A pilot model for predicting the success of prehospital endotracheal intubation.
abstract: OBJECTIVE
  We sought to evaluate the success of prehospital, non-drug-assisted endotracheal intubation (ETI) performed by Virginia prehospital care providers and to develop a model designed to predict the probability of success of ETI.
  
  
  METHODS
  We conducted a retrospective observational study on prehospital, non-drug-assisted ETI (N=4002) performed by Virginia prehospital care providers, from January 1, 2012, to December 31, 2012. Using descriptive statistics, we quantified patient, provider, and system characteristics. Success rates were calculated by provider certification level and number of ETI attempts. Procedure complications were evaluated for the entire cohort. Variables were recoded for modeling purposes. Univariate analyses using χ2 tests were performed to identify candidate parameters to be included in the model. We performed a backward stepwise logistic regression to predict ETI success.
  
  
  RESULTS
  An overall success rate of 69.9% was found. Binary logistic regression revealed the following covariates associated with ETI success: community type, provider certification level, gender, age group, myocardial infarction, and ethnicity which were all significant (P<0.05) with a -2 log-likelihood value of 3705.574. This was the most parsimonious model evaluated and demonstrated good fit (Hosmer-Lemeshow test P=.646) but poor discrimination (area under the receiver operating characteristic curve=0.595).
  
  
  CONCLUSIONS
  This study characterized prehospital ETI success using retrospective state data and found a low overall success rate. Binary logistic regression was performed to create a model and equation identifying a set of factors associated with ETI success.
authors.affiliation: Virginia Modeling Analysis and Simulation Center, Old Dominion University, Norfolk, VA, USA; Department of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA. Electronic address: ldigg004@odu.edu.
authors.forename: Leigh Ann
authors.initials: LA
authors.lastname: Diggs
authors.affiliation: Department of Mathematics and Statistics, College of Sciences, Old Dominion University, Norfolk, VA, USA. Electronic address: svisw002@odu.edu.
authors.forename: Sameera D
authors.initials: SD
authors.lastname: Viswakula
authors.affiliation: Department of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA; Center for Global Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA. Electronic address: msheth@odu.edu.
authors.forename: Manasi
authors.initials: M
authors.lastname: Sheth-Chandra
authors.affiliation: Respiratory Therapy Program, Department of Clinical and Environmental Health Sciences, College of Allied Health Sciences, Georgia Regents University, Augusta, GA, USA. Electronic address: gdeleo@gru.edu.
authors.forename: Gianluca
authors.initials: G
authors.lastname: De Leo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult