SynthesisCritical care (London, England)2017
A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients.
Synthesis in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- Endotracheal intubation to reduce aspiration events in acutely comatose patients: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Pooled it
- Prehospital severity and in-hospital mortality in trauma patients managed by the Friuli-Venezia Giulia helicopter emergency medical service: a 6-year retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Timing and outcomes of out-of-hospital traumatic cardiac arrest: results of a multicentre, retrospective cohort study.Resuscitation plus · 2026Article
- Airway management in trauma patients: A seven-year review of emergency department intubations.The American journal of emergency medicine · 2026Article
- Experiences of emergency care practitioners on pre-hospital rapid sequence intubation in South Africa.Health SA = SA Gesondheid · 2026Article
- Effect of different factors on predicting patient mortality beyond the NACA classification: a multivariate analysis of more than 2,000 polytrauma patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Standardized Rapid Sequence Intubation (RSI) Improves Effectiveness and Safety in Mixed Physician and Paramedic Hungarian EMS.Life (Basel, Switzerland) · 2025Article
- The Effect of Drug Selection on Pediatric Rapid Sequence Induction Success: A Systematic Review and Meta-Analysis.Cureus · 2025Review
- Enhancing geriatric trauma mortality prediction: Modifying and assessing the Geriatric Trauma Outcome Score with net benefit and decision curve analysis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Field vs. Emergency Department Intubation: A Retrospective Review of Hospital Outcomes of Trauma Patients.The western journal of emergency medicine · 2025Article
- Confined space airway management: a narrative review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
- Maintenance of prehospital anaesthesia in trauma patients: inconsistencies and variability in practice.BJA open · 2025Article
- x-ABC versus ABC: shifting paradigms in early trauma resuscitation.Trauma surgery & acute care open · 2025Review
- Helicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- 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
- Indications for prehospital intubation among severely injured children and the prevalence of significant traumatic brain injury among those intubated due to impaired level of consciousness.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- An independently validated nomogram for individualised estimation of short-term mortality risk among patients with severe traumatic brain injury: a modelling analysis of the CENTER-TBI China Registry Study.EClinicalMedicine · 2023Article
- Effects of the Lubo cervical collar on airway patency in awake adults - A magnetic resonance imaging study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- A retrospective descriptive analysis of non-physician-performed prehospital endotracheal intubation practices and performance in South Africa.BMC emergency medicine · 2022Article
- Risk factors and outcomes of unrecognised endobronchial intubation in major trauma patients.Emergency medicine journal : EMJ · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPre-hospital endotracheal intubation is frequently used for trauma patients in many emergency medical systems. Despite a wide range of publications in the field, it is debated whether the intervention is associated with a favourable outcome, when compared to more conservative airway measures.
methodsA systematic literature search was conducted to identify interventional and observational studies where the mortality rates of adult trauma patients undergoing pre-hospital endotracheal intubation were compared to those undergoing emergency department intubation.
resultsTwenty-one studies examining 35,838 patients were included. The median mortality rate in patients undergoing pre-hospital intubation was 48% (range 8-94%), compared to 29% (range 6-67%) in patients undergoing intubation in the emergency department. Odds ratios were in favour of emergency department intubation both in crude and adjusted mortality, with 2.56 (95% CI: 2.06, 3.18) and 2.59 (95% CI: 1.97, 3.39), respectively. The overall quality of evidence is very low. Twelve of the twenty-one studies found a significantly higher mortality rate after pre-hospital intubation, seven found no significant differences, one found a positive effect, and for one study an analysis of the mortality rate was beyond the scope of the article.
conclusionsThe rationale for wide and unspecific indications for pre-hospital intubation seems to lack support in the literature, despite several publications involving a relatively large number of patients. Pre-hospital intubation is a complex intervention where guidelines and research findings should be approached cautiously. The association between pre-hospital intubation and a higher mortality rate does not necessarily contradict the importance of the intervention, but it does call for a thorough investigation by clinicians and researchers into possible causes for this finding.
Indexed as
Identifiers
What OpenQuestion holds
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.