title: [No improved survival rate in severely injured patients by prehospital intubation : A retrospective data analysis and matched-pair analysis].
abstract: BACKGROUND
  Training programs for the treatment of trauma patients generally recommend establishing a secure airway if the patient presents with a Glasgow coma scale (GCS) score of less than 9; however, the evidence for its effectiveness is rather sparse. This study analyzed the effect of preclinical intubation on mortality of patients with a GCS <9 in an emergency medical situation.
  
  
  METHODS
  This retrospective analysis included patients who were primarily admitted to a German level 1 trauma center between 2002 and 2012 with an injury severity score (ISS) ≥ 16, a GCS < 9 and primary transport from the site of the accident. Data were collected from the trauma registry of the German Society for Trauma Surgery and from hospital records. A total of 455 patients were included and a matched-pair analysis of 62 patients was conducted.
  
  
  RESULTS
  Both analytical methods showed no significant reduction in mortality rate after prehospital intubation. In the retrospective analysis intubated patients presented with a significantly lower systolic blood pressure on admission, received a higher amount of fluid volume at all phases of treatment and arrived at the hospital after a prolonged rescue time. In the matched-pair analysis, intubated patients also received a higher amount of fluid volume and showed better peripheral oxygen saturation on admission. No further differences between the groups could be found.
  
  
  CONCLUSIONS
  It appears that preclinical intubation in trauma patients with a GCS < 9 does not result in a better outcome. The preclinical intubation resulted in a reduced systolic blood pressure on arrival at hospital, a prolonged preclinical rescue time and a greater amount of infused fluid volume.
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Alfried Krupp Krankenhaus Essen, Hellweg 100, 45276, Essen, Deutschland. carsten.schoeneberg@krupp-krankenhaus.de.
authors.forename: C
authors.initials: C
authors.lastname: Schoeneberg
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Wegner
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
authors.forename: M D
authors.initials: MD
authors.lastname: Kauther
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Stuermer
authors.affiliation: Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Städtische Kliniken Neuss, Neuss, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Probst
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Alfried Krupp Krankenhaus Essen, Hellweg 100, 45276, Essen, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Lendemans
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005440:Fluid Therapy / Q000401:mortality* / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000401:mortality* / Q000706:statistics & numerical data*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D014187:Transportation of Patients / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000145:classification / Q000401:mortality* / Q000451:nursing*; D055815:Young Adult
keywords: Glascow coma scale; Intubation; Mortality; Severely injured; Trauma