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dc.contributor.authorDowning, Jessica
dc.contributor.authorCardona, Stephanie
dc.contributor.authorAlfalasi, Reem
dc.contributor.authorShadman, Shahrad
dc.contributor.authorDhahri, Amina
dc.contributor.authorPaudel, Riddhi
dc.contributor.authorBuchongo, Portia
dc.contributor.authorSchwartz, Bradford
dc.contributor.authorTran, Quincy K
dc.date.accessioned2021-07-06T12:00:08Z
dc.date.available2021-07-06T12:00:08Z
dc.date.issued2021-06-09
dc.identifier.urihttp://hdl.handle.net/10713/16121
dc.description.abstractBackground: Awake prone positioning (PP) has been used to avoid intubations in hypoxic COVID-19 patients, but there is limited evidence regarding its efficacy. Moreover, clinicians have little information to identify patients at high risk of intubation despite awake PP. We sought to assess the intubation rate among patients treated with awake PP in our Emergency Department (ED) and identify predictors of need for intubation. Methods: We conducted a multicenter retrospective cohort study of adult patients admitted for known or suspected COVID-19 who were treated with awake PP in the ED. We excluded patients intubated in the ED. Our primary outcome was prevalence of intubation during initial hospitalization. Other outcomes were intubation within 48 h of admission and mortality. We performed classification and regression tree analysis to identify the variables most likely to predict the need for intubation. Results: We included 97 patients; 44% required intubation and 21% were intubated within 48 h of admission. Respiratory oxygenation (ROX) index and P/F (partial pressure of oxygen / fraction of inspired oxygen) ratio measured 24 h after admission were the variables most likely to predict need for intubation (area under the receiver operating characteristic curve = 0.82). Conclusions: Among COVID-19 patients treated with awake PP in the ED prior to admission, ROX index and P/F ratio, particularly 24 h after admission, may be useful tools in identifying patients at high risk of intubation.en_US
dc.description.urihttps://doi.org/10.1016/j.ajem.2021.06.010en_US
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc8188753/en_US
dc.language.isoenen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofAmerican Journal of Emergency Medicineen_US
dc.rightsCopyright © 2021 Elsevier Inc. All rights reserved.en_US
dc.subjectAwake proningen_US
dc.subjectCOVID-19en_US
dc.subjectCoronavirusen_US
dc.subjectIntubationen_US
dc.subjectMortalityen_US
dc.subjectProne positioningen_US
dc.titlePredictors of intubation in COVID-19 patients undergoing awake proning in the emergency departmenten_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.ajem.2021.06.010
dc.identifier.pmid34175731
dc.source.volume49
dc.source.beginpage276
dc.source.endpage286
dc.source.countryUnited States


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