Evidence map›Paper›PMID 34175731›Full record

ArticleThe American journal of emergency medicine2021

Predictors of intubation in COVID-19 patients undergoing awake proning in the emergency department.

Jessica Downing, Stephanie Cardona, Reem Alfalasi, Shahrad Shadman, Amina Dhahri, Riddhi Paudel, Portia Buchongo, Bradford Schwartz, Quincy K Tran

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Awake Prone Decubitus Positioning in COVID-19 Patients: A Systematic Review and MetaAnalysis.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023
    Article
  7. Review
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Jessica DowningDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: jvdowning@som.umaryland.edu.
Stephanie CardonaDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Reem AlfalasiDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Shahrad ShadmanDepartment of Medicine, University of Maryland Capital Region Health, Cheverly, MD, USA.
Amina DhahriDepartment of Medicine, University of Maryland Capital Region Health, Cheverly, MD, USA.
Riddhi PaudelRoss University School of Medicine, Miramar, FL, USA.
Portia BuchongoDepartment of Health Policy and Management, University of Maryland School of Public Health, College Park, MD, USA.
Bradford SchwartzDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Emergency Medicine, University of Maryland Capital Region Health, Prince George's Hospital Center, Cheverly, MD, USA.
Quincy K TranDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
University of Maryland, Baltimore · USUniversity of Maryland, College Park · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAwake prone positioning (PP) has been used to avoid intubations in hypoxic COVID-19 patients, but there is limited evidence regarding its efficacy. Moreover, clinicians have little information to identify patients at high risk of intubation despite awake PP. We sought to assess the intubation rate among patients treated with awake PP in our Emergency Department (ED) and identify predictors of need for intubation.

methodsWe conducted a multicenter retrospective cohort study of adult patients admitted for known or suspected COVID-19 who were treated with awake PP in the ED. We excluded patients intubated in the ED. Our primary outcome was prevalence of intubation during initial hospitalization. Other outcomes were intubation within 48 h of admission and mortality. We performed classification and regression tree analysis to identify the variables most likely to predict the need for intubation.

resultsWe included 97 patients; 44% required intubation and 21% were intubated within 48 h of admission. Respiratory oxygenation (ROX) index and P/F (partial pressure of oxygen / fraction of inspired oxygen) ratio measured 24 h after admission were the variables most likely to predict need for intubation (area under the receiver operating characteristic curve = 0.82).

conclusionsAmong COVID-19 patients treated with awake PP in the ED prior to admission, ROX index and P/F ratio, particularly 24 h after admission, may be useful tools in identifying patients at high risk of intubation.

Indexed as

Prone PositionWakefulnessCOVID-19Emergency Service, HospitalFemaleHumansHypoxiaIntubation, IntratrachealMaleMarylandMiddle AgedOxygen Inhalation TherapyRetrospective StudiesRisk AssessmentAwake proningCoronavirusCOVID-19IntubationMortalityProne positioning

Identifiers

PMID34175731
PMCPMC8188753
OpenAlexW3167418720

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.