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    IMPACT OF SETTING OF INJURY AND LEVEL OF TRAUMA CENTER ON TRAUMA MORTALITY AFTER FIELD INTUBATION

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    Genre
    Thesis/Dissertation
    Date
    2012
    Author
    Jayarajan, Senthil Nathan
    Advisor
    Nelson, Deborah B.
    Committee member
    Komaroff, Eugene
    Goldberg, Amy
    Department
    Public Health
    Subject
    Epidemiology
    Medicine
    Public Health
    Intubation
    Prehospital
    Rural
    Trauma
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/1529
    
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    DOI
    http://dx.doi.org/10.34944/dspace/1511
    Abstract
    Purpose: Pre-hospital intubation (PHI) in major trauma is associated with increased mortality. The goal of this study was to determine if PHI is protective in patients injured in rural vs. urban locations or patients transferred to level II vs. level I trauma centers. Methods: The Pennsylvania Trauma Outcomes Study database from 2006 - 2011 was reviewed. Pediatric patients, burns, patients dead on arrival, and transfers were excluded. Patients receiving PHI were compared to those immediately transported. Results: Of 63264 trauma patients, 2725 (4.31%) were intubated in the field. Mortality was higher among the intubated than those not intubated (28.22% vs. 4.11%, p<0.0001). The intubated cohort had greater mean Injury Severity Score (ISS) (27.77 vs.13.33, p<0.0001). Factors associated with mortality on multivariate logistic regression included PHI (OR 6.284, p<.0001), ISS>25 (OR 35.384, p<.0001), penetrating trauma (OR 5.685, p<.0001), transport to level II trauma center (OR 1.151, p=
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