EBQ:Prehospital Hypoxia in Brain Trauma - Revision history

Danbot: Added Major Points, Interventions, and Funding sections

2026-03-21T22:44:35Z

Added Major Points, Interventions, and Funding sections

← Revisión anterior		Revisión del 22:44 21 mar 2026
Línea 20:		Línea 20:
	==Conclusion==		==Conclusion==
	Secondary insults after TBI are common, and these insults are associated with disability. Hypoxia in the prehospital setting significantly increases the odds of mortality after brain injury controlled for multiple variables.		Secondary insults after TBI are common, and these insults are associated with disability. Hypoxia in the prehospital setting significantly increases the odds of mortality after brain injury controlled for multiple variables.

			==Major Points==
			*This landmark study demonstrated that prehospital hypoxia (SpO2 <90%) in TBI patients is independently associated with significantly increased mortality
			*Prehospital hypotension (SBP <90mmHg) combined with hypoxia had the worst outcomes, with mortality approaching 75%
			*Even a single episode of prehospital hypoxia doubled the odds of death compared to normoxic patients
			*The study reinforced the importance of aggressive airway management and oxygenation in the prehospital setting for TBI patients
			*Results have influenced prehospital trauma guidelines to prioritize early correction of hypoxia and hypotension

	==Design==		==Design==
Línea 33:		Línea 40:
	#determination of a nonsurvivable injury (based on an AIS score of 6 for any body region)		#determination of a nonsurvivable injury (based on an AIS score of 6 for any body region)
	#death in less than 12 hours after injury		#death in less than 12 hours after injury

			==Interventions==
			*No specific intervention; this was a prospective observational study
			*Prehospital vital signs (SpO2, blood pressure) were recorded by paramedics at the scene
			*Patients received standard prehospital trauma care per local protocols
			*Hypoxia was defined as SpO2 <90% and hypotension as SBP <90 mmHg

	==Outcomes==		==Outcomes==
Línea 80:		Línea 93:

	</quiz>		</quiz>
			==Funding==
			*National Institutes of Health (NIH)
			*Centers for Disease Control and Prevention (CDC)

	==Sources==		==Sources==
	<references/>		<references/>

	[[Category:EBQ]][[Category:Pulmonary]]		[[Category:EBQ]][[Category:Pulmonary]]

Ostermayer: Reverted edits by Ostermayer (talk) to last revision by ClaireLewis

2017-03-10T07:55:19Z

Reverted edits by Ostermayer (talk) to last revision by ClaireLewis

← Revisión anterior		Revisión del 07:55 10 mar 2017
Línea 66:		Línea 66:
	{In the authors' '''previous work''' looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?		{In the authors' '''previous work''' looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?
	\|type="[]"}		\|type="[]"}
	+[[Hypotension]]but not hypoxia are associated with increased mortality.		+Hypotension but not hypoxia are associated with increased mortality.
	-Hypoxia but not hypotension are associated with increased mortality.		-Hypoxia but not hypotension are associated with increased mortality.
	-Both hypotension and hypoxia are associated with increased mortality.		-Both hypotension and hypoxia are associated with increased mortality.
Línea 73:		Línea 73:
	{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?		{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?
	\|type="[]"}		\|type="[]"}
	-[[Hypotension]]but not hypoxia are associated with increased mortality.		-Hypotension but not hypoxia are associated with increased mortality.
	+Hypoxia but not hypotension are associated with increased mortality.		+Hypoxia but not hypotension are associated with increased mortality.
	-Both hypotension and hypoxia are associated with increased mortality.		-Both hypotension and hypoxia are associated with increased mortality.

Ostermayer: Text replacement - "Hypotension " to "Hypotension"

2017-03-10T07:47:01Z

Text replacement - "Hypotension " to "Hypotension"

← Revisión anterior		Revisión del 07:47 10 mar 2017
Línea 66:		Línea 66:
	{In the authors' '''previous work''' looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?		{In the authors' '''previous work''' looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?
	\|type="[]"}		\|type="[]"}
	+Hypotension but not hypoxia are associated with increased mortality.		+[[Hypotension]]but not hypoxia are associated with increased mortality.
	-Hypoxia but not hypotension are associated with increased mortality.		-Hypoxia but not hypotension are associated with increased mortality.
	-Both hypotension and hypoxia are associated with increased mortality.		-Both hypotension and hypoxia are associated with increased mortality.
Línea 73:		Línea 73:
	{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?		{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?
	\|type="[]"}		\|type="[]"}
	-Hypotension but not hypoxia are associated with increased mortality.		-[[Hypotension]]but not hypoxia are associated with increased mortality.
	+Hypoxia but not hypotension are associated with increased mortality.		+Hypoxia but not hypotension are associated with increased mortality.
	-Both hypotension and hypoxia are associated with increased mortality.		-Both hypotension and hypoxia are associated with increased mortality.

ClaireLewis: /* Subgroup Analysis */

2016-08-10T18:05:01Z

Subgroup Analysis

← Revisión anterior		Revisión del 18:05 10 ago 2016
Línea 45:		Línea 45:

	==Subgroup Analysis==		==Subgroup Analysis==
	Univariate analysis with independent variables included were age, ~~gender~~, mechanism of injury, GCS score, ISS score, AIS score, field resuscitation and intubation, transport time and distance, CT Marshall score, presence of lung injury (defined as lung AIS score >3), presence of multiple trauma (defined as an AIS score >3 for two or more body regions or organs), and surgical procedure (craniotomy vs. noncraniotomy) performed after hospitalization.		Univariate analysis with independent variables included were age, sex, mechanism of injury, GCS score, ISS score, AIS score, field resuscitation and intubation, transport time and distance, CT Marshall score, presence of lung injury (defined as lung AIS score >3), presence of multiple trauma (defined as an AIS score >3 for two or more body regions or organs), and surgical procedure (craniotomy vs. noncraniotomy) performed after hospitalization.

	The independent variables that were identified as affecting mortality were: hypoxia, older age, lower GCS score, Marshall score, head AIS score, and multiple traumatic injuries significantly affected mortality.		The independent variables that were identified as affecting mortality were: hypoxia, older age, lower GCS score, Marshall score, head AIS score, and multiple traumatic injuries significantly affected mortality.

Ostermayer: Text replacement - "Category:Pulm" to "Category:Pulmonary"

2016-03-22T16:12:13Z

Text replacement - "Category:Pulm" to "Category:Pulmonary"

← Revisión anterior		Revisión del 16:12 22 mar 2016
Línea 83:		Línea 83:
	<references/>		<references/>

	[[Category:EBQ]][[Category:~~Pulm~~]]		[[Category:EBQ]][[Category:Pulmonary]]

Ostermayer: /* Subgroup Analysis */

2014-02-13T04:13:06Z

Subgroup Analysis

← Revisión anterior		Revisión del 04:13 13 feb 2014
Línea 48:		Línea 48:

	The independent variables that were identified as affecting mortality were: hypoxia, older age, lower GCS score, Marshall score, head AIS score, and multiple traumatic injuries significantly affected mortality.		The independent variables that were identified as affecting mortality were: hypoxia, older age, lower GCS score, Marshall score, head AIS score, and multiple traumatic injuries significantly affected mortality.
	~~[[File:Preox table.png\|thumbnail]]~~
	Multivariate analysis accounting for the above independent variables showed that hypoxia was an independent predictor of mortality (OR 2.66, p 0.05). Age >65 years and GCS score <8 were also significant predictors of mortality in multivariate analysis, but hypotension was not.		Multivariate analysis accounting for the above independent variables showed that hypoxia was an independent predictor of mortality (OR 2.66, p 0.05). Age >65 years and GCS score <8 were also significant predictors of mortality in multivariate analysis, but hypotension was not.

Ostermayer at 04:12, 13 February 2014

2014-02-13T04:12:29Z

← Revisión anterior		Revisión del 04:12 13 feb 2014
Línea 48:		Línea 48:

	The independent variables that were identified as affecting mortality were: hypoxia, older age, lower GCS score, Marshall score, head AIS score, and multiple traumatic injuries significantly affected mortality.		The independent variables that were identified as affecting mortality were: hypoxia, older age, lower GCS score, Marshall score, head AIS score, and multiple traumatic injuries significantly affected mortality.
			[[File:Preox table.png\|thumbnail]]
	Multivariate analysis accounting for the above independent variables showed that hypoxia was an independent predictor of mortality (OR 2.66, p 0.05). Age >65 years and GCS score <8 were also significant predictors of mortality in multivariate analysis, but hypotension was not.		Multivariate analysis accounting for the above independent variables showed that hypoxia was an independent predictor of mortality (OR 2.66, p 0.05). Age >65 years and GCS score <8 were also significant predictors of mortality in multivariate analysis, but hypotension was not.

Cklchao at 20:59, 12 February 2014

2014-02-12T20:59:15Z

← Revisión anterior		Revisión del 20:59 12 feb 2014
Línea 64:		Línea 64:
	-75 to 100%		-75 to 100%

	{In the ~~author~~'s previous work looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?		{In the authors' '''previous work''' looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?
	\|type="[]"}		\|type="[]"}
	+Hypotension but not hypoxia are associated with increased mortality.		+Hypotension but not hypoxia are associated with increased mortality.

Cklchao at 20:56, 12 February 2014

2014-02-12T20:56:44Z

← Revisión anterior		Revisión del 20:56 12 feb 2014
Línea 63:		Línea 63:
	-50 to 75%		-50 to 75%
	-75 to 100%		-75 to 100%

			{In the author's previous work looking at secondary injury in TBI patients '''in the ED''', what did they find regarding association with mortality?
			\|type="[]"}
			+Hypotension but not hypoxia are associated with increased mortality.
			-Hypoxia but not hypotension are associated with increased mortality.
			-Both hypotension and hypoxia are associated with increased mortality.
			-Neither hypotension nor hypoxia are associated with increased mortality.

	{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?		{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?

Cklchao at 20:03, 12 February 2014

2014-02-12T20:03:31Z

← Revisión anterior		Revisión del 20:03 12 feb 2014
Línea 63:		Línea 63:
	-50 to 75%		-50 to 75%
	-75 to 100%		-75 to 100%


	~~{Prior to this study the majority of research demonstrated which findings regarding secondary injury and mortality in TBI?~~
	~~\|type="[]"}~~
	~~+Hypotension but not hypoxia are associated with increased mortality.~~
	~~-Hypoxia but not hypotension are associated with increased mortality.~~
	~~-Both hypotension and hypoxia are associated with increased mortality.~~
	~~-Neither hypotension nor hypoxia are associated with increased mortality.~~

	{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?		{After multivariate analysis what did this study find regarding secondary injury and mortality in the '''prehospital setting''' and TBI?