Emergent airway management outside of the operating room - A retrospective review of patient characteristics, complications and ICU stay

Uzung Yoon, Jeffrey Mojica, Matthew Wiltshire, Kara Segna, Michael Block, Anthony Pantoja, Marc Torjman, Elizabeth Wolo

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward. Methods: We retrospectively collected data on all emergent airway management interventions performed outside of the operating room over a 6-month period. Documentation included intubation performance, and intubation related complications and mortality. Additional information including demographics, ASA-classification, comorbidities, hospital-stay, ICU-stay, and 30-day in-hospital mortality was obtained. Results: 336 intubations were performed in 275 patients during the six-month period. The majority of intubations (n = 196, 58%) occurred in an ICU setting, and the rest 140 (42%) occurred on a normal floor or in a remote location. The mean admission ASA status was 3.6 ± 0.5, age 60 ± 16 years, and BMI 30 ± 9 kg/m2. Chest X-rays performed immediately after intubation showed main stem intubation in 3.3% (n = 9). Two immediate (within 20 min after intubation) intubation related cardiac arrest/mortality events were identified. The 30-day in-hospital mortality was 31.6% (n = 87), the overall in-hospital mortality was 37.1% (n = 102), the mean hospital stay was 22 ± 20 days, and the mean ICU-stay was 14 days (13.9 ± 0.9, CI 12.1-15.8) with a 7.3% ICU-readmission rate. Conclusion: Patients requiring emergent airway management are a high-risk patient population with multiple comorbidities and high ASA scores on admission. Only a small number of intubation-related complications were reported but ICU length of stay was high.

Original languageEnglish (US)
Article number220
JournalBMC Anesthesiology
Volume19
Issue number1
DOIs
StatePublished - Dec 3 2019
Externally publishedYes

Keywords

  • Cardiac arrest
  • Emergent airway
  • Intubation
  • Mortality
  • Outside the operating room

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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