First-Attempt Success Between Anatomically and Physiologically Difficult Airways in the National Emergency Airway Registry
Authors' conclusion
Compared to no difficult airway characteristics, ADAs were inversely associated with first-attempt success, while PDAs were not. Both ADAs and PDAs, as well as their interaction, were inversely associated with first-attempt success without adverse events.
Study context
- Population
- Adult (age ≥14 years) emergency department (ED) intubations with sedation and paralysis using direct or video laryngoscopy, National Emergency Airway Registry, 2016–2018; cardiac arrest excludedof 19,071 intubated
- Participants
- 13,938 participants
- Exposure
- Anatomically difficult airway (anticipated difficult airways (ADA)), physiologically difficult airway (PDA), or both vs neither
- Outcome
- First-attempt success
Methodological detailsobservational, registry-based, mixed-effects models
- Observational
- Registry-based
- Mixed-effects models
Main finding
As reported in the abstract
AOR for first-attempt success (95% CI)
ADA alone vs Neither
0.53(0.40–0.68)
PDA alone vs Neither
0.96(0.68–1.36)
ADA and PDA vs Neither
0.44(0.34–0.56)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR for first-attempt success without adverse events (95% CI) | |
|---|---|---|
| First-attempt success without adverse eventsADA alone vs Neither | 0.72 (0.59–0.89) | |
| First-attempt success without adverse eventsPDA alone vs Neither | 0.79 (0.62–1.01) | |
| First-attempt success without adverse eventsADA and PDA vs Neither | 0.44 (0.37–0.54) | |
| 0.20.5125AOR for first-attempt success without adverse events (log scale) |
First-attempt success without adverse events
- No evidence that the ADA–PDA interaction differed from additive
Original publication
First-Attempt Success Between Anatomically and Physiologically Difficult Airways in the National Emergency Airway Registry. Anesth Analg. Published 9 February 2024. doi:10.
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