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Table 2 Univariate analysis: Association of variables with hypotension (defined as a new SBP < 90 mmHg ≤ 10 min of induction, or a > 10% drop if SBP was < 90 mmHg pre-PHEA) for adult trauma patients who underwent PHEA in the East of England, 2015–2020

From: Predictors of post-intubation hypotension in trauma patients following prehospital emergency anaesthesia: a multi-centre observational study

Variable

Coefficient

P-value

Sex

 Male

REF

 

 Female

0.230

0.183*

Age/years

 16–34

REF

 

 35–54

0.120

0.547

 55–74

0.349

0.084*

 75 +

0.269

0.297

Estimated patient weight

− 0.002

0.691

GCS score

− 0.029

0.136*

Suspected injury pattern

 Isolated head injury

REF

 

 Head injury + thorax/abdomen

0.749

< 0.001*

 No head injury

0.666

0.004*

Trauma type

 Blunt

REF

 

 Penetrating

0.100

0.809

Mechanism

 Transport

REF

 

 Accidental Injury

0.0817

0.630

 Assault

− 0.354

0.375

 Self-harm

0.611

0.075*

 Sport/leisure

− 0.345

0.490

Shock index (SI)

0.818

< 0.001*

Pre-PHEA SBP/mmHg,

 Mid (90–140)

REF

 

 Low (< 90)

0.233

0.304

 High (> 140)

− 0.998

< 0.001*

Pre-PHEA HR/beats/minute

 Mid (60–100)

REF

 

 Low (< 60)

0.326

0.268

 High (> 100)

0.697

< 0.001*

Pre-PHEA RR/breaths/minute

 Mid (10–25)

REF

 

 High (> 25)

0.353

0.058*

 Low (< 10)

0.071

0.837

PHEA drug regime (fentanyl:ketamine:rocuronium)

 3:2:1

REF

 

 1:1:1

0.687

0.036*

 0:1:1

1.566

< 0.001*

 0:0:1 (Roc only)

1.914

0.007*

 Other

0.694

0.042*

Indication for PHEA

 Reduced consciousness

REF

 

 Airway obstruction/compromise

− 0.004

0.984

 Ventilatory failure

0.523

0.017*

 Agitated head injury

− 0.174

0.503

 Anticipated clinical course

− 0.070

0.807

 Other

− 13.250

0.976

Arrival time to PHEA/minutes

− 0.007

0.336

Pre-PHEA fluids

 None

REF

 

 Fluids

0.558

< 0.001*

  1. The shock index was calculated as HR/SBP. ‘Arrival to PHEA’ is the time in minutes from the HEMS team arrival on scene until the time of PHEA. Pre-PHEA fluids are intravenous crystalloid administration by the ambulance service before arrival of HEMS
  2. *P < 0.25 (threshold for including in first iteration of multivariate model)
  3. PHEA prehospital emergency anaesthetic, GCS Glasgow Coma Scale, RSI rapid sequence induction, HR heart rate, SBP systolic blood pressure, RR respiratory rate