| Item type |
デフォルトアイテムタイプ（フル）fmu(1) |
| 公開日 |
2016-09-01 |
| タイトル |
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|
タイトル |
Association between off-hour presentation and endotracheal-intubation-related adverse events in trauma patients with a predicted difficult airway: A historical cohort study at a community emergency department in Japan |
|
言語 |
en |
| 作成者 |
Ono, Yuko
Sugiyama, Takuya
Chida, Yasuyuki
Sato, Tetsuya
Kikuchi, Hiroaki
Suzuki, Daiji
Ikeda, Masakazu
Tanigawa, Koichi
Shinohara, Kazuaki
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| 権利情報 |
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|
権利情報Resource |
http://creativecommons.org/licenses/by/4.0/ |
|
権利情報 |
© 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| 内容記述 |
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内容記述タイプ |
Abstract |
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内容記述 |
Background: A reduction in medical staff such as occurs in hospitals during nights and weekends (off hours) is associated with a worse outcome in patients with several unanticipated critical conditions. Although difficult airway management (DAM) requires the simultaneous assistance of several appropriately trained medical caregivers, data are scarce regarding the association between off-hour presentation and endotracheal intubation (ETI)-related adverse events, especially in the trauma population. The aim of this study was to determine whether off-hour presentation was associated with ETI complications in injured patients with a predicted difficult airway. Methods: This historical cohort study was conducted at a Japanese community emergency department (ED). All patients with inhalation burn, comminuted facial trauma (Abbreviated Injury Scale Score Face ≥3), and penetrating neck injury who underwent ETI from January 2007 to January 2016 in our ED were included. Primary exposure was off-hour presentation, defined as the period from 6:01 PM to 8:00 AM weekdays plus the entire weekend. The primary outcome measure was the occurrence of an ETI-related adverse event, including hypoxemia, unrecognized esophageal intubation, regurgitation, cardiac arrest, ETI failure rescued by emergency surgical airway, cuff leak, and mainstem bronchus intubation. Results: Of the 123 patients, 75 (61.0 %) were intubated during off hours. Crude analysis showed that off-hour presentation was significantly associated with an increased risk of ETI-related adverse events [odds ratio (OR), 2.5; 95 % confidence interval (CI), 1.1–5.6; p = 0.033]. The increased risk remained significant after adjusting for potential confounders, including operator being an anesthesiologist, use of a paralytic agent, and injury severity score (OR, 3.0; 95 % CI, 1.1–8.4; p = 0.034). Conclusions: In this study, off-hour presentation was independently associated with ETI-related adverse events in trauma patients with a predicted difficult airway. These data imply the need for more attentive hospital care during nights and weekends. |
| 出版者 |
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|
出版者 |
BioMed Central |
| 言語 |
|
|
言語 |
eng |
| 書誌情報 |
en : Scandinavian journal of trauma, resuscitation and emergency medicine
巻 24,
p. 106,
発行日 2016-08-30
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| 関連情報 |
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|
関連タイプ |
isIdenticalTo |
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識別子タイプ |
DOI |
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関連識別子 |
https://doi.org/10.1186/s13049-016-0296-2 |
| 関連情報 |
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|
識別子タイプ |
PMID |
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関連識別子 |
27576447 |
| 資源タイプ |
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|
資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
|
資源タイプ |
journal article |
| 出版タイプ |
|
|
出版タイプ |
VoR |
|
出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| 収録物識別子 |
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収録物識別子タイプ |
EISSN |
|
収録物識別子 |
1757-7241 |
| 主題 |
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|
主題Scheme |
Other |
|
主題 |
Airway management |
| 主題 |
|
|
主題Scheme |
Other |
|
主題 |
Comminuted facial trauma |
| 主題 |
|
|
主題Scheme |
Other |
|
主題 |
Difficult airway management |
| 主題 |
|
|
主題Scheme |
Other |
|
主題 |
Fatal complication |
| 主題 |
|
|
主題Scheme |
Other |
|
主題 |
Inhalational burn |
| 主題 |
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|
主題Scheme |
Other |
|
主題 |
Penetrating neck injury |
ScandJTraumaResuscEmergMed_24_106.pdf (560.8 KB)
