The relationship between prehospital endotracheal intubation and the postoperative pulmonary infection in patients with traumatic brain injury

Abstract

Objective To investigate the impacts of prehospital endotracheal intubation on postoperative pulmonary infection in the patients with severe traumatic brain injury. Methods Retrospectively, the clinical data of 284 patients with severe traumatic brain injury admitted in the 97th Hospital of PLA from July 2007 to December 2012 were analyzed. The patients were classified into two groups according to the timing of endotracheal intubation, namely, prehospital intubation group and admission intubation group. The postoperative pulmonary infection incidence, occurrence time, and the duration of treatment of the two groups were studied. Results The incidences of postoperative pulmonary infection in patients intubated before and after admission were 38.0% and 25.2% respectively. Pulmonary infection occurred in the prehospital intubation group was at the (9.9±0.6) d after admission, and in the admission intubation group was at the (11.6±0.3) d after admission. The duration of treatment for postoperative pulmonary infection was (21.2±7.2) days and (14.5±9.0) days respectively. Compared with the patients intubated after admission, patients intubated before admission suffered higher incidence (P <0.05) , earlier onset (P <0.05) , and longer treatment duration of pulmonary infection (P <0.01). Conclusions Severe traumatic brain injury patients with prehospital endotracheal intubation are more susceptible to pulmonary infection. Avoiding the tracheal injury and bacterial contamination in the procedure could reduce the incidence of pulmonary infection. Key words: Trauma; Brain injury; Pulmonary infection; Endotracheal intubation; Prehospital; Postoperation; Complication; Prevention