Table 4.
Summary of findings
| Prehospital intubation compared to emergency department intubation for unconscious trauma patients: | |||||
|---|---|---|---|---|---|
| Outcomes | Number of participants (studies) Follow up | Quality of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* | |
| Risk with emergency department intubation | Risk difference with prehospital intubation | ||||
| Morality (RSI) | 2299 (5 observational studies) | Very lowa, b, c | OR 2.42 (1.32 to 4.42) | 334 per 1 000 | 214 more per 1000 (64 more to 355 more) |
| Mortality (no RSI/some RSI) | 33,539 (12 observational studies) | Very lowa, b, d, e | OR 2.60 (2.03 to 3.33) | 382 per 1 000 | 234 more per 1000 (174 more to 291 more) |
| Mortality, GCS similar and <8 (RSI) | 503 (2 observational studies) | Very lowa, b, c | OR 1.11 (0.75 to 1.65) | 260 per 1 000 | 21 more per 1000 (51 fewer to 107 more) |
| Mortality, GCS similar and <8 (no RSI/some RSI) | 19,824 (2 observational studies) | Very lowa, b, d | OR 2.57 (2.38 to 2.77) | 439 per 1 000 | 229 more per 1000 (212 more to 245 more) |
| Patients with no difference in injury severity | 1690 (4 observational studies) | Very lowa, b, c | OR 1.94 (1.02 to 3.70) | 372 per 1 000 | 163 more per 1000 (5 more to 315 more) |
CI confidence interval, OR odds ratio, RSI rapid sequence induction, GCS Glasgow coma score. GRADE Working Group grades of evidence: high quality - we are very confident that the true effect lies close to that of the estimate of the effect; moderate quality - we are moderately confident in the effect estimate: the true effect is likely to be close the estimate of the effect, but there is a possibility that it is substantially different; low quality - our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect; very low quality - we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect
aObservational studies
bHigh I squared score implies uncertain effect estimate, but most studies have overlapping CI
cThe only source of high-quality evidence includes no effect, in contrast to the remaining studies
dWidely defined patient populations across studies
eOptimal size criterion met and combined 95% CI excludes no effect
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)