ArticleEmergency medicine journal : EMJ2014
Association of out-of-hospital advanced airway management with outcomes after traumatic brain injury and hemorrhagic shock in the ROC hypertonic saline trial.
Article in Emergency medicine journal : EMJ, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- The effectiveness of prehospital hypertonic saline for hypotensive trauma patients: a systematic review and meta-analysis.BMC emergency medicine · 2017Pooled it
- A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients.Critical care (London, England) · 2017Pooled it
- Pooled it
- Glasgow Outcome Scale Measures and Impact on Analysis and Results of a Randomized Clinical Trial of Severe Traumatic Brain Injury.Journal of neurotrauma · 2019Trial
- Field vs. Emergency Department Intubation: A Retrospective Review of Hospital Outcomes of Trauma Patients.The western journal of emergency medicine · 2025Article
- Predictors of Short-Term Trauma Laparotomy Outcomes in an Integrated Military-Civilian Health System: A 23-Year Retrospective Cohort Study.Journal of clinical medicine · 2024Article
- Prehospital and emergency department airway management of severe penetrating trauma in Sweden during the past decade.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Observational
- Endotracheal intubation in trauma patients with isolated shock: universally recommended but rarely performed.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- A trauma-related survival predictive model of acute respiratory distress syndrome.Journal of clinical laboratory analysis · 2021Article
- Multiple trauma management in mountain environments - a scoping review : Evidence based guidelines of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Intended for physicians and other advanced life support personnel.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Article
- Prehospital tidal volume influences hospital tidal volume: A cohort study.Journal of critical care · 2015Observational
- Airway management of patients with traumatic brain injury/C-spine injury.Korean journal of anesthesiology · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
Abstract
objectivePrior studies suggest adverse associations between out-of-hospital advanced airway management (AAM) and patient outcomes after major trauma. This secondary analysis of data from the Resuscitation Outcomes Consortium Hypertonic Saline Trial evaluated associations between out-of-hospital AAM and outcomes in patients suffering isolated severe traumatic brain injury (TBI) or haemorrhagic shock.
methodsThis multicentre study included adults with severe TBI (GCS ≤8) or haemorrhagic shock (SBP ≤70 mm Hg, or (SBP 71-90 mm Hg and heart rate ≥108 bpm)). We compared patients receiving out-of-hospital AAM with those receiving emergency department AAM. We evaluated the associations between airway strategy and patient outcomes (28-day mortality, and 6-month poor neurologic or functional outcome) and airway strategy, adjusting for confounders. Analysis was stratified by (1) patients with isolated severe TBI and (2) patients with haemorrhagic shock with or without severe TBI.
resultsOf 2135 patients, we studied 1116 TBI and 528 shock; excluding 491 who died in the field, did not receive AAM or had missing data. In the shock cohort, out-of-hospital AAM was associated with increased 28-day mortality (adjusted OR 5.14; 95% CI 2.42 to 10.90). In TBI, out-of-hospital AAM showed a tendency towards increased 28-day mortality (adjusted OR 1.57; 95% CI 0.93 to 2.64) and 6-month poor functional outcome (1.63; 1.00 to 2.68), but these differences were not statistically significant. Out-of-hospital AAM was associated with poorer 6-month TBI neurologic outcome (1.80; 1.09 to 2.96).
conclusionsOut-of-hospital AAM was associated with increased mortality after haemorrhagic shock. The adverse association between out-of-hospital AAM and injury outcome is most pronounced in patients with haemorrhagic shock.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.