[Effect of intubation timing on the clinical course of polytrauma patients with lung contusions]

Abstract

Aim of the study was to evaluate the influence of early intubation at the scene on the outcome of polytraumatized patients with lung-contusion.

Methods: 377 patients with lung-contusion out of 1031 polytraumatized patients were evaluated in this study. Patients, intubated at the scene were compared with those, who were intubated later. We compared the in-hospital time, the time at the ICU, the pneumonia-rate and the ARDS-rate. Age and injury severity of the compared groups were comparable.

Results: In-hospital time and time at the ICU were shorter in the early intubated group than in the later intubated (in-hospital time 34.5 d and 39.4 d, time at the ICU 19.9 d and 23.7 d, resp.). For the time at the ICU the difference is significant. Also a reduction was found in the pneumoniarates (23.7% and 13.2%). The ARDS rate was reduced, too, but both differences were not significant (ppneumonia = 0.053, pARDS = 0.117). The mortality also was not significantly reduced (23.4% and 22.7%, resp.).

Conclusion: Early intubation at the scene can reduce the inhospital-time, the time at the ICU and the complications. In this way it becomes an important factor of cost-reduction. Therefore early intubation at the scene must become a standard for all patients with lung-contusion.