Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study
An erratum to this article was published (Crit Care, 10 Jun 2025 ↗)
Main finding · 28-day mortalityResult — go to the resultAdjusted hazard ratio 1.43 95% CI 1.26–1.62Authors' conclusion
One in three patients undergoing emergency intubation experienced a major peri-intubation adverse event, which was associated with higher 28-day mortality.
Study context
- Population
- Adults (≥ 18 years) undergoing emergency intubation in 18 EDs in Brazil (March 2022-April 2024); elective or cardiac arrest intubations excluded
- Participants
- 2,846 adults · 18 EDs
- Exposure
- Any major peri-intubation adverse event vs none
- Major adverse eventn = 919
- Outcome
- Mortality
- Follow-up
- 28 days
Methodological detailsmulticentre
- Multicentre
Main finding
28-day mortality
Adjusted hazard ratio
1.43
95% CI 1.26–1.62
P < 0.001
By group
Major adverse event
57.6
%
No major adverse event
39.2%
Major adverse event vs No major adverse event
aHR 1.43 (95% CI 1.26–1.62); P < 0.001
As reported in the abstract
- Overall 28-day mortality
- 45.1%
Observational data: associations, not effects.
Further findings
Successful first-attempt intubation and major adverse events
| aOR for major adverse events (95% CI) | P value | ||
|---|---|---|---|
| Successful first-attempt intubationAssociated with a reduced likelihood of major adverse events | 0.52 (0.41–0.65) | P < 0.001 | |
| 0.512AOR for major adverse events (log scale) |
Major peri-intubation adverse events (overall incidence and by type) · within 30 min of initiating intubation
- Any major adverse event
- 919 (32.3%)
- New hemodynamic instability
- 20.0%
- Severe hypoxemia
- 12.5%
- Cardiac arrest
- 3.5%
Overall 28-day mortality
- Overall 28-day mortality
- 45.1%
Original publication
Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study. Crit Care. Published 17 April 2025. doi:10.
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