The purpose of this study was to evaluate early endotracheal intubation (ETI) on favorable neurological outcomes at 1 month after OHCA.
We extracted patients who were performed ETI on the scene from nationwide OHCA database registered between 2014 and 2015. Total of 7410 patients with 15 to 115 years old and recorded ETI time were analyzed. Subjects were divided into shockable(n=) and non-shockable(n=) because of potential differences in the treatment protocol, and they additionally parted into three phases (Early, 1-8min; Middle, 9-12min ; Late, 13-27min) by tertile of ETI time respectively. Multivariable logistic regression was applied to estimating of odds ratio for the favorable neurological outcomes (CPC1-2) rate and ROSC rate.
In the shockable cohort, Early had the highest rate of CPC1-2(Early vs. Middle vs. Late, 12.7% vs. 6.6% vs. 4.9%) and ROSC (Early vs Middle vs Late, 27.3% vs 15.8% vs 14.6%) among all phases. Early compared with Late was significantly associated with ROSC (adjusted odds ratios, 3.67; 95%CI, 1.99-6.79), but there was no association between insertion phases and CPC1-2.
In the non-shockable cohort, Early had the highest rate of CPC1-2 (Early vs. Middle vs. Late; 1.6% vs. 1.0% vs. 0.9%) and ROSC (Early vs. Middle vs. Late; 22.1% vs. 19.4% vs. 11.8%) among all phases. Early compared with Late was significantly associated with CPC1-2(adjusted odds ratios, 1.81; 95%CI, 1.02-3.22), and Early and Middle were significantly associated with ROSC (adjusted odds ratios, 2.87,2.21 ;95%CI, 2.39-3.44, 1.82-2.67, respectively).
Inserting ETI in the early phase at the scene for OHCA might be more effective than that in the late period to improve patients’ neurological outcomes.