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Table 4 Results of meta-analysis for all adverse events between direct laryngoscope and video laryngoscope

From: Comparison of adverse events between video and direct laryngoscopes for tracheal intubations in emergency department and ICU patients–a systematic review and meta-analysis

Outcomes Studies, N Participants, N Heterogeneity Heterogeneity Statistical method Effect Estimate P values
Rate of EI 18 11,187 P = 0.05; I2 = 39% RR (M-H, Fixed, 95% CI) 0.24 [0.18, 0.32] P < 0.01
Rate of EI (RCT) 7 1232 P = 0.70; I2 = 0% RR (M-H, Fixed, 95% CI) 0.27 [0.13, 0.57] P < 0.01
Rate of EI (non-RCT) 11 9955 P = 0.01; I2 = 57% RR (M-H, Fixed, 95% CI) 0.24 [0.18, 0.32] P < 0.01
Rate of EI (CPR) 4 3723 P = 0.44; I2 = 0% RR (M-H, Fixed, 95% CI) 0.27 [0.15, 0.49] P < 0.01
Rate of EI (non-CPR) 15 7464 P = 0.03; I2 = 46% RR (M-H, Fixed, 95% CI) 0.23 [0.17, 0.31] P < 0.01
Rate of EI (experienced) 5 1100 P = 0.45; I2 = 0% RR (M-H, Fixed, 95% CI) 0.44 [0.17, 1.15] P = 0.09
Rate of EI (inexperienced) 12 9807 P = 0.02; I2 = 50% RR (M-H, Fixed, 95% CI) 0.23 [0.17, 0.31] P < 0.01
Rate of EI (unknown expertise) 1 280 Not applicable RR (M-H, Fixed, 95% CI) 0.38 [0.02, 6.94] P = 0.51
Incidence of hypoxemia 4 1548 P = 0.35; I2 = 8% RR (M-H, Fixed, 95% CI) 0.85 [0.69, 1.05] P = 0.14
Incidence of hypoxemia (RCT) 2 510 P = 0.34; I2 = 0% RR (M-H, Fixed, 95% CI) 0.91 [0.56, 1.47] P = 0.70
Incidence of hypoxemia (non-RCT) 2 1038 P = 0.13; I2 = 56% RR (M-H, Fixed, 95% CI) 0.83 [0.66, 1.05] P = 0.13
Incidence of hypoxemia (experienced) 2 393 P = 0.70; I2 = 0% RR (M-H, Fixed, 95% CI) 1.05 [0.77, 1.43] P = 0.76
Incidence of hypoxemia (inexperienced) 2 1155 P = 0.89; I2 = 0% RR (M-H, Fixed, 95% CI) 0.71 [0.53, 0.96] P = 0.03
Incidence of severe hypoxemia 8 1739 P = 0.26; I2 = 22% RR (M-H, Fixed, 95% CI) 1.13 [0.83, 1.52] P = 0.44
Incidence of severe hypoxemia (RCT) 4 787 P = 0.18; I2 = 39% RR (M-H, Fixed, 95% CI) 1.11 [0.66, 1.87] P = 0.39
Incidence of severe hypoxemia (non-RCT) 4 952 P = 0.26; I2 = 26% RR (M-H, Fixed, 95% CI) 1.13 [0.78, 1.64] P = 0.52
Incidence of severe hypoxemia (experienced) 2 393 P = 0.46; I2 = 0% RR (M-H, Fixed, 95% CI) 1.16 [0.62, 2.16] P = 0.65
Incidence of severe hypoxemia (inexperienced) 6 1346 P = 0.14; I2 = 40% RR (M-H, Fixed, 95% CI) 1.12 [0.79, 1.58] P = 0.53
Incidence of aspiration 13 4634 P = 0.98; I2 = 0% RR (M-H, Fixed, 95% CI) 0.83 [0.60, 1.16] P = 0.28
Incidence of aspiration (RCT) 7 1751 P = 0.79; I2 = 0% RR (M-H, Fixed, 95% CI) 0.90 [0.52, 1.58] P = 0.72
Incidence of aspiration (non-RCT) 6 2883 P = 0.92; I2 = 0% RR (M-H, Fixed, 95% CI) 0.80 [0.53, 1.21] P = 0.28
Incidence of aspiration (CPR) 1 140 Not applicable RR (M-H, Fixed, 95% CI) 5.58 [0.25, 126.46] P = 0.28
Incidence of aspiration (non-CPR) 13 4494 P = 0.97; I2 = 0% RR (M-H, Fixed, 95% CI) 0.83 [0.59, 1.16] P = 0.27
Incidence of aspiration (experienced) 6 1769 P = 0.88; I2 = 0% RR (M-H, Fixed, 95% CI) 0.65 [0.32, 1.32] P = 0.24
Incidence of aspiration (inexperienced) 7 2865 P = 0.92; I2 = 0% RR (M-H, Fixed, 95% CI) 0.90 [0.61, 1.31] P = 0.57
Incidence of new-onset CA 7 2433 P = 0.20; I2 = 31% RR (M-H, Fixed, 95% CI) 1.52 [0.63, 3.66] P = 0.35
Incidence of new-onset CA (RCT) 4 795 P = 0.56; I2 = 0% RR (M-H, Fixed, 95% CI) 3.51 [0.73, 16.92] P = 0.12
Incidence of new-onset CA (non-RCT) 3 1638 P = 0.09; I2 = 58% RR (M-H, Fixed, 95% CI) 0.86 [0.27, 2.70] P = 0.79
Incidence of new-onset CA (experienced) 1 163 Not applicable RR (M-H, Fixed, 95% CI) 3.04 [0.13, 73.46] P = 0.49
Incidence of new-onset CA (inexperienced) 6 2270 P = 0.14; I2 = 43% RR (M-H, Fixed, 95% CI) 1.42 [0.57, 3.56] P = 0.45
24 h-mortality 6 1477 P = 0.82; I2 = 0% RR (M-H, Fixed, 95% CI) 1.29 [0.98, 1.69] P = 0.07
24 h-mortality (RCT) 3 646 P = 1.00; I2 = 0% RR (M-H, Fixed, 95% CI) 3.06 [0.49, 19.25] P = 0.23
24 h-mortality (non-RCT) 3 831 Not applicable RR (M-H, Fixed, 95% CI) 1.23 [0.94, 1.62] P = 0.13
24 h-mortality (CPR) 1 229 Not applicable RR (M-H, Fixed, 95% CI) 1.23 [0.94, 1.62] P = 0.13
24 h-mortality (non-CPR) 5 1248 P = 1.00; I2 = 0% RR (M-H, Fixed, 95% CI) 3.06 [0.49, 19.25] P = 0.23
24 h-mortality (experienced) 1 164 Not applicable RR (M-H, Fixed, 95% CI) 3.07 [0.13, 74.35] P = 0.49
24 h-mortality (inexperienced) 5 1313 P = 0.73; I2 = 0% RR (M-H, Fixed, 95% CI) 1.27 [0.97, 1.67] P = 0.08
28 d-mortality 7 1821 P = 0.98; I2 = 0% RR (M-H, Fixed, 95% CI) 1.04 [0.92, 1.19] P = 0.52
28 d-mortality (RCT) 5 1382 P = 0.90; I2 = 0% RR (M-H, Fixed, 95% CI) 1.04 [0.86, 1.26] P = 0.66
28 d-mortality (non-RCT) 2 439 P = 0.82; I2 = 0% RR (M-H, Fixed, 95% CI) 1.04 [0.88, 1.23] P = 0.62
28 d-mortality (CPR) 1 229 Not applicable RR (M-H, Fixed, 95% CI) 1.03 [0.86, 1.23] P = 0.76
28 d-mortality (non-CPR) 6 1592 P = 0.95; I2 = 0% RR (M-H, Fixed, 95% CI) 1.05 [0.89, 1.24] P = 0.57
28 d-mortality (experienced) 2 821 P = 0.94; I2 = 0% RR (M-H, Fixed, 95% CI) 1.22 [0.83, 1.79] P = 0.32
28 d-mortality (inexperienced) 5 1000 P = 0.99; I2 = 0% RR (M-H, Fixed, 95% CI) 1.01 [0.88, 1.16] P = 0.88
  1. Abbreviations: EI Esophageal intubation, CA Cardiac arrest, RCT Randomized controlled trial, CPR Cardiopulmonary resuscitation, RR Risk ratio, M-H Mantel-Haenszel