Increased mortality in trauma patients who develop postintubation hypotension.

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Critical Care

Background:

• Postintubation hypotension (PIH) is a known complication of emergency endotracheal intubation (ETI) in critically ill patients.
• The impact of PIH on outcomes specifically within the trauma population has not been well-defined.

Purpose of the Study:

• To determine the prevalence of PIH in trauma patients requiring ETI.
• To assess the association between PIH and patient outcomes, including mortality.

Main Methods:

• Retrospective case series of adult trauma patients intubated on arrival at a tertiary trauma center (2000-2015).
• Data extracted from trauma registry and patient charts, including demographics, comorbidities, intubation details, and vital signs.
• Logistic regression analysis used to compare mortality rates between PIH and non-PIH groups.

Main Results:

• The prevalence of PIH was 36.3% (161/444) among eligible trauma patients.
• In-hospital mortality was significantly higher in the PIH group (29.8%) compared to the non-PIH group (15.9%; p=0.001).
• PIH was associated with increased odds of mortality in the ED (aOR 3.45) and in-hospital (aOR 1.83).

Conclusions:

• Postintubation hypotension is a common occurrence in trauma patients undergoing ETI.
• PIH is independently associated with increased mortality in this patient population.
• Intubation practices in critically ill trauma patients warrant further investigation due to patient safety implications.