BACKGROUND Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward. METHODS We retrospectively collected data on all emergent airway management interventions performed outside of the operating room over a 6-month period. Documentation included intubation performance, and intubation related complications and mortality. Additional information including demographics, ASA-classification, comorbidities, hospital-stay, ICU-stay, and 30-day in-hospital mortality was obtained. RESULTS 336 intubations were performed in 275 patients during the six-month period. The majority of intubations (n = 196, 58%) occurred in an ICU setting, and the rest 140 (42%) occurred on a normal floor or in a remote location. The mean admission ASA status was 3.6 ± 0.5, age 60 ± 16 years, and BMI 30 ± 9 kg/m2. Chest X-rays performed immediately after intubation showed main stem intubation in 3.3% (n = 9). Two immediate (within 20 min after intubation) intubation related cardiac arrest/mortality events were identified. The 30-day in-hospital mortality was 31.6% (n = 87), the overall in-hospital mortality was 37.1% (n = 102), the mean hospital stay was 22 ± 20 days, and the mean ICU-stay was 14 days (13.9 ± 0.9, CI 12.1-15.8) with a 7.3% ICU-readmission rate. CONCLUSION Patients requiring emergent airway management are a high-risk patient population with multiple comorbidities and high ASA scores on admission. Only a small number of intubation-related complications were reported but ICU length of stay was high.

中文翻译：

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手术室外紧急气道管理-回顾性检查患者特征，并发症和ICU停留时间。

背景技术在手术室外部进行紧急气道管理是高风险的过程。关于插管时患者的适应症和生理状态，发生位置或之后的患者预后的数据有限。方法我们回顾性收集了在六个月内在手术室外进行的所有紧急气道管理干预措施的数据。文件包括插管的性能，以及与插管相关的并发症和死亡率。获得了其他信息，包括人口统计学，ASA分类，合并症，住院，ICU住院和30天住院死亡率。结果在六个月内对275例患者进行了336次插管。大多数插管（n = 196，58％）发生在ICU设置中，其余140人（占42％）发生在正常地板上或偏远地区。ASA的平均入院状态为3.6±0.5，年龄60±16岁，BMI为30±9 kg / m2。插管后立即进行的胸部X光检查显示主干插管占3.3％（n = 9）。确定了两个即时（在插管后20分钟内）与插管有关的心脏骤停/死亡事件。30天住院死亡率为31.6％（n = 87），总体住院死亡率为37.1％（n = 102），平均住院时间为22±20天，平均ICU停留时间为14天（13.9±0.9，CI 12.1-15.8），重症监护病房再入院率为7.3％。结论需要紧急气道处理的患者是高危患者，合并有多种合并症，入院时ASA评分高。