Abstract 17660: Association Between Prehospital Oxygen Administration and Mortality in Severe Trauma Patients (PROMIS)

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Abstract

Introduction: We routinely give oxygen for trauma patients in prehospital settings although there are no obvious evidences of the efficacy. We want to clarify whether prehospital oxygen administration (POA) contributes to in-hospital mortality or not.

Hypothesis: POA will increase survival rate in trauma patients.

Methods: This was a multicenter prospective observational study using the Japan Trauma Data Bank (JTDB). 70683 patients with trauma and 15 years or older were eligible from 2004-2010. Of which, 32,225 (45.6%) patients with complete data set of important data were used in the analysis. Main outcome is the survival to hospital discharge by POA

Results: Of 32,225 trauma patients, 19,985 (62.0%) were administrated with oxygen and 12,240 (38.0%) were not administrated with oxygen by emergency medical services (EMS) in prehospital settings. Overall, 29555 patients (90.7%) survived to hospital discharge. In multivariable unconditional logistic regression, POA had an OR for favorable in-hospital mortality of 0.33 (95% CI, 0.30-0.37; P<0.001). After adjusting for selected data (arrived Grasgow Coma Scale: aGCS, arrived Respiratory Rate: aRR, arrived Systolic Blood Pressure: aSBP), POA use was not associated with low risk of in-hospital mortaliry (adjusted odds ratio [OR], 0.88; 95% confidence interval [CI], 0.76-1.01; P=0.12). Even after adjusted all covariates of data, POA is not improve in-hospital mortality (adjusted odds ratio [OR], 0.89; 95% confidence interval [CI], 0.76-1.04; P=0.16). Furthermore, because POA and no POA grorup are significant differeneces in all of important data (P<0.001), we used a propensity score matching analysis. After adjusted the covariates of selected data (aGCS, aRR, aSBP), POA was not associated with a higher rate of survival after in-hospital mortality compared with no POA use (adjusted odds ratio [OR], 1.02; 95% confidence interval [CI], 0.99-1.04; P=0.27). Even after adjusted all covariates of data, POA is not improve in-hospital mortality (adjusted odds ratio [OR], 1.01; 95% confidence interval [CI], 0.99-1.03; P=0.08).

Conclusions: POA did not improve in-hospital mortality in trauma patients in this study.

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