European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study
Effect of age on the association between the Glasgow Coma Scale and the anatomical brain lesion severity: a retrospective multicentre study.
Background and importance Older adults are at higher risk of undertriage and mortality following a traumatic brain injury (TBI). Early identification and accurate triage of severe cases is therefore critical. However, the Glasgow Coma Scale (GCS) might lack sensitivity in older patients. ⋯ Older adults had increased odds of mortality compared to their younger counterparts at all AIS-head levels: AIS-head = 3 [odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6-5.5], AIS-head = 4, (OR = 2.7, 95% CI 1.6-4.7) and AIS-head = 5 (OR = 2.6, 95% CI 1.9-3.6) TBI (all P < 0.001). Similar results were found among patients with multiple trauma. Conclusions In this study, among TBI patients with similar AIS-head score, there was a significant higher median GCS in older patients compared to younger patients.
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Letter Multicenter Study Observational Study
Abdominal point-of-care ultrasound for the exclusion of bowel obstruction: prospective multicentre observational study.
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Multicenter Study
Comparison of seven prehospital early warning scores to predict long-term mortality: a prospective, multicenter, ambulance-based study.
A prospective, multicenter, ambulance-based study of adult patients with an acute illness involving six advanced life support units and 38 basic life support units, referring to five emergency departments in Spain. ⋯ Among seven tested EWS, the use of the MREMS presented better characteristics to predict 1-year mortality; however, all these scores present moderate performances.
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Multicenter Study
Association between out-of-hospital cardiac arrest and survival in paediatric traumatic population: results from the French national registry.
Trauma is an important cause of paediatric out-of-hospital cardiac arrest (OHCA) with a high mortality rate. ⋯ In this post-hoc analysis, paediatric traumatic OHCA was associated with a lower survival rate than medical cardiac arrest.
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Multicenter Study
Factors associated with tracheal intubation-related complications in the prehospital setting: a prospective multicentric cohort study.
Background Emergency tracheal intubation is routinely performed in the prehospital setting. Airway management in the prehospital setting has substantial challenges. Objective The aim of the present study was to determine risk factors predicting tracheal intubation-related complications on the prehospital field. ⋯ In the multivariate analysis, we found that the leading risk factors for tracheal intubation-related complications were Cormack and Lehane grade 3 and 4 [odds ratio (OR) = 1.65; 95% confidence interval (CI), 1.05-2.61; and OR = 2.79; 95% CI, 1.56-4.98, respectively], a BMI of more than 30 (OR = 1.61; 95% CI, 1.13-2.28), when intubation was difficult (OR = 1.72; 95% CI, 1.15-2.57), and when tracheal intubation required more than one operator (OR = 2.30; 95% CI, 1.50-3.49). Conclusions In this prospective study, we found that Cormack and Lehane more than grade 2, BMI >30, difficult intubation, and tracheal intubation requiring more than one operator were all independent predictors of tracheal intubation-related complications in the prehospital setting. When these risk factors are identified on scene, adapted algorithms that anticipate the use of a bougie should be generalized to reduce morbidity on the prehospital field.