Abstract 16603: The Association Between Tracheal Intubation During Adult In-hospital Cardiac Arrest and Survival
Background: Tracheal intubation is very common during in-hospital cardiac arrest. However, little is known about the association between tracheal intubation and survival in this setting.
Methods: We analyzed data from the Get With The Guidelines® - Resuscitation registry, which is a multicenter registry of in-hospital cardiac arrest. Our exposure was tracheal intubation during the cardiac arrest and the primary outcome was survival to hospital discharge. Patients being intubated at any given minute (from 0 to 15 minutes) were matched with patients at risk of being intubated within the same minute (i.e. still receiving resuscitation) based on a time-dependent propensity score calculated from multiple patient, event, and hospital characteristics.
Results: 108,079 adult patients were included from 668 hospitals. 71,615 patients (66%) were intubated within the first 15 minutes. 86,628 patients were included in the propensity-matched cohort. Survival was lower in those intubated compared to those not intubated: 7052/43,314 (16.3%) vs. 8407/43,314 (19.4%), risk ratio: 0.84 (95%CI: 0.81, 0.87), p < 0.001. The proportion of patients with return of spontaneous circulation was lower in those intubated: 25,022/43,311 (57.8%) vs. 25,685/43,310 (59.3%), risk ratio: 0.97 (95%CI: 0.96, 0.99), p < 0.001. Good functional outcome (cerebral performance category 1-2) was also lower in those intubated: 4439/41,868 (10.6%) vs. 5672/41,733 (13.6%), risk ratio: 0.78 (95%CI: 0.75, 0.81), p < 0.001. These results remained robust in sensitivity analyses. Although important differences existed in pre-specified subgroup analyses, tracheal intubation was not associated with improved outcomes in any subgroup.
Conclusions: Tracheal intubation during in-hospital cardiac arrest is common and is associated with decreased survival to hospital discharge.
Author Disclosures: L.W. Andersen: None. A. Granfeldt: None. C. Callaway: None. S.M. Bradley: None. J. Soar: None. J.P. Nolan: None. T. Kurth: None. M.W. Donnino: Employment; Modest; American Heart Association.
- © 2016 by American Heart Association, Inc.