For a study, the researchers sought to investigate the relationship between intubation timing and clinical outcomes in critically ill patients. PubMed was systematically searched for studies comparing the mortality of critically ill patients who were intubated early versus late. Because a relevant meta-analysis had already been published, studies involving patients with new coronavirus disease (COVID-19) were excluded. According to the authors of the included studies, “early” intubation was defined. The primary outcome was all-cause mortality. A random-effects model was used to calculate the pooled risk ratio (RR) and 95% confidence intervals (CI). PROSPERO was used to register the meta-analysis. There were 27 studies in total, with 15,441 intubated patients (11,943 early, 3498 late). Patients undergoing early versus late intubation had lower all-cause mortality (7338 deaths; 45.8% versus 53.5%; RR 0.92, 95% CI 0.87–0.97; p=0.001). This was also true in a sensitivity analysis of studies that defined “early” as intubation within 24 hours of ICU admission (6279 deaths; 45.8% versus 53.6%; RR 0.93, 95% CI 0.89–0.98; p=0.005). In critically ill patients without COVID-19, avoiding late intubation might be associated with lower mortality.
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