About: Questioning dogma: does a GCS of 8 require intubation?

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Questioning dogma: does a GCS of 8 require intubation?
Creator	Dumas, Ryan Hatchimonji, Justin Holena, Daniel Kaufman, Elinore Scantling, Dane Stoecker, Jordan
Source	PMC
abstract	BACKGROUND: There is no evidence supporting intubation for a Glasgow Coma Scale (GCS) of 8. We investigated the effect of intubation in trauma patients with a GCS 6–8, with the hypothesis that intubation would increase mortality and length of stay. METHODS: We studied adult patients with GCS 6–8 from the 2016 National Trauma Data Bank. Intubated and non-intubated patients were compared using inverse probability weighted regression adjustment (IPWRA) to control for injury severity and patient characteristics. Outcomes were mortality, intensive care unit length of stay (ICU LOS), and total LOS. Stratified analysis was performed to investigate the effect in patients with and without head injuries. RESULTS: Among 6676 patients with a GCS between 6 and 84,078 were intubated within 1 h of arrival to the emergency department. The overall mortality rate was 15.1%. IPWRA revealed an increase in mortality associated with intubation (OR 1.05, 95% CI 1.03, 1.06). The results were similar in patients with head injuries (OR 1.04, 95% CI 1.02, 1.06) and without (OR 1.06, 95% CI 1.03, 1.10). Among the 5,742 patients admitted to the ICU, intubation was associated with a 14% increase in ICU LOS (95% CI 8–20%; 5.5 vs. 4.8 days; p < 0.001). The overall length of stay was 27% longer (95% CI 19.8–34.3%) among intubated patients (mean 7.7 vs 6.0 days; p < 0.001). CONCLUSION: Among patients with GCS of 6 to 8, intubation on arrival was associated with an increase in mortality and with longer ICU and overall length of stay. The use of a strict threshold GCS to mandate intubation should be revisited.
has issue date	2020-05-07(xsd:dateTime)
bibo:doi	10.1007/s00068-020-01383-4
bibo:pmid	32382780
has license	no-cc
sha1sum (hex)	f27ab36ff6a2aed53fcc28f19a3688a239afa4ef
schema:url	https://doi.org/10.1007/s00068-020-01383-4
resource representing a document's title	Questioning dogma: does a GCS of 8 require intubation?
has PubMed Central identifier	PMC7223660
has PubMed identifier	32382780
schema:publication	Eur J Trauma Emerg Surg
resource representing a document's body	covid:f27ab36ff6a2aed53fcc28f19a3688a239afa4ef#body_text
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