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Table 4 Summary of findings

From: A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients

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)

  1. 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
  2. aObservational studies
  3. bHigh I squared score implies uncertain effect estimate, but most studies have overlapping CI
  4. cThe only source of high-quality evidence includes no effect, in contrast to the remaining studies
  5. dWidely defined patient populations across studies
  6. eOptimal size criterion met and combined 95% CI excludes no effect
  7. *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)
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Critical Care

ISSN: 1364-8535