Airway management is a crucial part of out-of-hospital care. It is not known if the rate of overall agency intubation attempts is associated with intubation success. We sought to evaluate the association between agency intubation attempt rate and intubation success using a national out-of-hospital database. We conducted a retrospective secondary analysis of the ESO Data Collaborative from 2018 to 2019, and included all adult cases with an endotracheal intubation attempt. We calculated the number of intubations attempted per 100 responses, advanced life support responses, and transports for each agency. We excluded cases originating at health care facilities and outliers. We used multivariable logistic regression to evaluate the association between agency intubation attempt rate and 1) intubation success and 2) first-pass success. We adjusted for confounders. We included 1,005 agencies attempting 58,509 intubations. Overall, the intubation success rate was 78.8%, and the first-pass success rate was 68.5%. Per agency, the median rate of intubation attempts per 100 emergency medical service responses was 0.8 (interquartile range 0.6 to 1.1). Rates of intubation attempts per 100 responses (adjusted odds ratio [aOR] 1.7; 95% confidence interval [CI] 1.6 to 1.8), advanced life support responses (aOR 1.18; 95% CI 1.16 to 1.20), and transports (aOR 1.21; 95% CI 1.18 to 1.22) were all associated with intubation success. These relationships were similar for first-pass success but with smaller effect sizes. Higher agency rates of intubation attempts were associated with increased rates of intubation success and first-pass success.

中文翻译：

---

紧急医疗服务机构插管率与插管成功之间的关系

气道管理是院外护理的重要组成部分。目前尚不清楚整体机构插管尝试率是否与插管成功相关。我们试图使用国家院外数据库来评估机构插管尝试率与插管成功之间的关联。我们对 2018 年至 2019 年的 ESO 数据协作进行了回顾性二次分析，包括所有尝试气管插管的成人病例。我们计算了每个机构每 100 次响应、高级生命支持响应和转运尝试插管的次数。我们排除了源自医疗机构的病例和异常值。我们使用多变量逻辑回归来评估机构插管尝试率与 1) 插管成功和 2) 首次成功之间的关联。我们针对混杂因素进行了调整。我们纳入了 1,005 家机构，尝试进行 58,509 次插管。总体而言，插管成功率为78.8%，首次通过成功率为68.5%。每个机构每 100 次紧急医疗服务响应的插管尝试中位数为 0.8 次（四分位数范围为 0.6 至 1.1）。每 100 次反应的插管尝试率（调整后优势比 [aOR] 1.7；95% 置信区间 [CI] 1.6 至 1.8）、高级生命支持反应（aOR 1.18；95% CI 1.16 至 1.20）和转运（aOR 1.21；95% CI 1.16 至 1.20）。 95% CI（1.18 至 1.22）均与插管成功相关。这些关系与首次成功的关系相似，但效果较小。插管尝试的代理率越高，插管成功率和首次成功率越高。