{"id":24815,"date":"2023-11-15T04:13:00","date_gmt":"2023-11-14T20:13:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24815"},"modified":"2023-11-15T11:49:05","modified_gmt":"2023-11-15T03:49:05","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%af%94%e8%be%83%e6%97%a9%e6%9c%9f%e6%88%96%e5%bb%b6%e8%bf%9f%e6%b0%94%e7%ae%a1%e6%8f%92%e7%ae%a1%e7%ad%96%e7%95%a5%e7%9a%84%e6%a8%a1%e4%bb%bf","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24815","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u6bd4\u8f83\u65e9\u671f\u6216\u5ef6\u8fdf\u6c14\u7ba1\u63d2\u7ba1\u7b56\u7565\u7684\u6a21\u4eff\u76ee\u6807\u8bd5\u9a8c"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH|\u00a0VOLUME 164, ISSUE 4<\/a>,\u00a0P885-891,\u00a0OCTOBER 2023<\/p>\n\n\n\n

Emulating Target Trials Comparing Early and Delayed Intubation Strategies<\/h1>\n\n\n\n

Kerollos Nashat Wanis, Arin L. Madenci, Sicheng Hao, et al<\/h3>\n\n\n\n

Chest 2023; 164: 885-891 Published: May 05, 2023<\/h3>\n\n\n\n

DOI: https:\/\/doi.org\/10.1016\/j.chest.2023.04.048<\/a><\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

Whether intubation should be initiated early in the clinical course of critically ill patients remains a matter of debate. Results from prior observational studies are difficult to interpret because of avoidable flaws including immortal time bias, inappropriate eligibility criteria, and unrealistic treatment strategies.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Do treatment strategies that intubate patients early in the critical care admission improve 30-day survival compared with strategies that delay intubation?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

We estimated the effect of strategies that require early intubation of critically ill patients compared with those that delay intubation. With data extracted from the Medical Information Mart for Intensive Care-IV database, we emulated three target trials, varying the flexibility of the treatment strategies and the baseline eligibility criteria.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Under unrealistically strict treatment strategies with broad eligibility criteria, the 30-day mortality risk was 7.1 percentage points higher for intubating early compared with delaying intubation (95%\u00a0CI, 6.2-7.9). Risk differences were 0.4 (95%\u00a0CI, \u20130.1 to 0.9) and \u20130.9 (95%\u00a0CI, \u20132.5 to 0.7) percentage points in subsequent target trial emulations that included more realistic treatment strategies and eligibility criteria.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

When realistic treatment strategies and eligibility criteria are used, strategies that delay intubation result in similar 30-day mortality risks compared with those that intubate early. Delaying intubation ultimately avoids intubation in most patients.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCH|\u00a0VOLUME 164, ISSUE 4,\u00a0 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24815"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24815"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24815\/revisions"}],"predecessor-version":[{"id":24816,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24815\/revisions\/24816"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24815"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24815"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24815"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}