Critical Care: ICU Management and Outcomes |

ED Intubation Is Associated With Pulmonary Complications FREE TO VIEW

Krishna Akella, DO; Sraavya Undurty, BS; Akella Chendrasekhar, MD
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Richmond University Medical Center, Staten Island, NY

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):290A. doi:10.1016/j.chest.2016.08.303
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SESSION TITLE: ICU Management and Outcomes

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 25, 2016 at 08:45 AM - 10:00 AM

PURPOSE: We noticed a variability in outcomes for our trauma patients, who were intubated in different locations within the hospital. We hypothesized that intubation performed in the emergency department (ED) is a predictive marker of increased incidence of in-hospital complications.

METHODS: A retrospective data analysis was performed. Intubations performed in four different locations: ED, operating room (OR), intensive care unit (ICU), and the surgical floor. Demographic data obtained included location of intubation, age, Injury Severity Score (ISS), days on a ventilator, incidence of pulmonary infection, length of stay in ICU, hospital length of stay and survival.

RESULTS: 96 patients were enrolled (13 women, 83 men), ED (61) floor (10), ICU (13), and OR (12). The mean age was 49.5 years. Patients intubated in the ED, as compared to floor, ICU and OR, in had higher ventilator days (10.9 vs. 5 vs. 5.2 vs. 1.75, p=0.0003), ICU length of stay (12.2 vs. 6.9 vs. 7.0 vs. 4.9, p=0.0015) and hospital length of stay (18.8 vs. 10.4 vs. 10.7 vs. 7.8, p=0.0283). ED patients also had a significantly higher incidence of pulmonary infection than the other three locations (p=0.0015). ISS was statistically not different between the groups (p=0.106). Survival between the groups was not different.

CONCLUSIONS: ED intubation was found to be significantly correlated with incidence of pulmonary infection, ventilator days, ICU length of stay and hospital length of stay. The location of intubation did not impact survival.

CLINICAL IMPLICATIONS: ED intubations is associated with pulmonary complications requiring close monitoring.

DISCLOSURE: The following authors have nothing to disclose: Krishna Akella, Sraavya Undurty, Akella Chendrasekhar

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