Table 2.
Clinical information
| Study ID | Mortality PHI | Mortality EDI | ISS PHI | ISS EDI | GCS PHI | GCS EDI | Percentage in shock/average SBP PHI | Percentage in shock/average SBP EDI | AOR PHI vs. EDI | Methodological quality determined by assessment tool | Conclusion of article |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Al-Thani 2014 [27] | 126/239 | 45/243 | 25.3 | 21.3 | 6.9 | 12.1 | avg 127.9 | avg. 129.4 | AOR 2.4 (0.61–9.44) GCS, ISS, head injury | Fair | PHI associated with worse outcome |
| Arbabi 2004 [28] | Not specified | Not specified | AOR in favour of PHI 3.0 (1.9–4.9). Compared to patients not intubated at all, AOR 1.1 (0.7–1.9) | Poor | PHI associated with better outcome, but analysis included GCS in paralyzed patients | ||||||
| Bernard 2010 [29] | 53/160 | 55/152 | 30.5 | 30.1 | 5 | 5 | avg 128 | avg 129 | Randomized patients, no AOR given | Good | PHI had no significant impact on mortality, but improved neurological outcome |
| Bochicchio 2003 [30] | 18/78 | 14/113 | 20.1 | 19.2 | 4 | 4.4 | avg 105 | avg 111 | No adjustments made, but no significant differences between groups | Fair | PHI associated with worse outcome |
| Bukur 2011 [31] | 55/61 | 286/2305 | 26.7 | 18.4 | 3.3 | 11.7 | 73.8 | 4.5 | 5 (1.7–13.7), adjusted for mechanism of injury, mean SBP, hypotension, mean GCS, GCS <8, head AIS, mean ISS, ISS >16 | Fair | PHI associated with worse outcome |
| Davis 2005 (I) [33] | 1390/2414 | 537/1833 | 36.6 | 28.3 | 4.4 | 8 | 72 | 50 | AOR 2.12 (1.81–2.5). AOR in article given as an inverse variant (0.47 (0.40–0.55). Corrected for age, gender, mechanism of injury, GCS, head AIS, ISS, shock | Fair | PHI associated with worse outcome |
| Davis 2005 (II) [32] | 531/1250 | 428/993 | AOR 1.42 (1.13–1.78) adjusted for age, sex, mechanism, preadmission hypotension, head AIS, ISS and pre-intubation GCS | Fair | PHI by aeromedical teams associated with better outcome than EDI after ground transport | ||||||
| Eckert 2004 [35] | 26 | 18 | 4 | 8 | avg 132 | avg 132 | No AOR given | Fair | PHI associated with worse outcome | ||
| Eckert 2006 [34] | 16/62 | 51/353 | 21 | 19 | 5 | 7 | avg 104 | avg 125 | AOR for intubation in the field 2.3 (1.1-4.9), ED 3.6 (2.5-5.2), inpatient 0.28 (0.2–0.4) | Fair | PHI associated with worse outcome |
| Eckstein 2000 [36] | 87/93 | 268/403 | 35 | 29 | AOR for pre-hospital intubation 5.3 (2.3–14.2). Corrected for sex, mechanism of injury and ISS | Fair | PHI associated with worse outcome | ||||
| Evans 2010 [38] | 32/412 | 10/160 | 27.2 | 27 | 4.1 | 11.6 | avg 122,4 | avg 125,5 | No AOR given | Fair | No significant differences in outcomes between groups |
| Evans 2013 [37] | 182/269 | 315/758 | 31 | 26 | 3 | 6 | 28.8 | 15.3 | Logistic regression analysis including hypotension, age, ISS, GCS. Pre-hospital intubation 2.8 (1.1–7.6) Trauma centre intubation 2.6 (1.3–5.6) | Fair | PHI associated with worse outcome |
| Franschman 2011 [39] | 101/233 | 42/103 | 32 | 25 | 3 | 5 | 23 | 11 | No AOR given | Fair | No significant differences in outcomes between groups |
| Irvin 2010 [40] | 1539/2491 | 2985/8457 | 31.6 | 24.2 | 3 | 3 | avg 121,3 | avg 130,1 | Corrected for ISS, SBP, penetrating or blunt trauma, age, head injuries and improved GCS en route. For all patients AOR 1.93 (1.74–2.15) Head injury only AOR 1.99 (1.35–2.93) Body injury only AOR 2.54 (1.85–3.48) |
Fair | PHI associated with worse outcome |
| Oswalt 1992 [41] | 9/18 | 9/26 | 31.4 | 24.7 | 5.2 | 5.9 | avg 78,5 | avg 131 | No AOR given | Fair | No significant differences in outcomes between groups |
| Shafi 2005 [42] | 818/1185 | 4105/7601 | 35 | 33 | 3.7 | 4.1 | 48 | 33 | Logistic regression including age, ISS, specific injuries, pre-existing conditions, PH-fluids and CPR. Survival 0.531 (0.441–0.65) Inverse value: 1.88 (1.54–2.32) |
Fair | PHI associated with worse outcome |
| Sloane 2000 [17] | 3/21 | 12/54 | 31.4 | 29 | 5.2 | 5.8 | No AOR given | Fair | No significant differences in mortality between groups, but higher occurrence of pneumonia in PHI group | ||
| Sollid 2010 [43] | 108/240 | 10/47 | 3 | 6 | No AOR given | Fair | Beyond scope of article | ||||
| Tracy 2006 [44] | 86/271 | 101/357 | 25.3 | 22.4 | 4 | 8.3 | No AOR given | Fair | No significant differences in outcomes between groups | ||
| Tuma 2014 [45] | 57/105 | 17/105 | 28 | 27 | avg 129 | avg 142 | Unclear rationale for AOR | Fair | PHI associated with worse outcome | ||
| Vandromme 2011 [46] | 30/64 | 35/85 | 38 | 33.7 | 4.1 | 5.9 | avg 127,4 | avg 151,3 | Adjusted for GCS, SBP, RR and ISS. Adjusted RR 0.68 (0.36–1.19). Not possible to work out adjusted odds ratio | Fair | No significant differences in outcomes between groups |
| Wang 2004 [47] | 871/1797 | 649/2301 | 21.8 | 8.7 | Multivariate logistic regression with ISS, AIS-head and admission SBP. AOR 3.99 (3.21–4.93) | Fair | PHI associated with worse outcome |
PHI pre-hospital intubation, EDI emergency department intubation, ISS injury severity score, GCS Glasgow coma scale, SBP systolic blood pressure, avg average, AOR adjusted odds ratio, ED emergency department, RR risk ratio , AIS abbreviated injury scale