Prior work has found first-attempt success improves with emergency medicine (EM) postgraduate year (PGY). However, the association between PGY and laryngoscopic view – a key step in successful intubation – is unknown. We examined the relationship among PGY, laryngoscopic view (ie, Cormack–Lehane view), and first-attempt success. We performed a retrospective analysis of the National Emergency Airway Registry, including adult intubations by EM PGY 1 to 4 resident physicians. We used inverse probability weighting with propensity scores to balance confounders. We used weighted regression and model comparison to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CIs) between PGY and Cormack–Lehane view, tested the interaction between PGY and Cormack–Lehane view on first-attempt success, and examined the effect modification of Cormack–Lehane view on the association between PGY and first-attempt success. After exclusions, we included 15,453 first attempts. Compared to PGY 1, the aORs for a higher Cormack–Lehane grade did not differ from PGY 2 (1.01; 95% CI 0.49 to 2.07), PGY 3 (0.92; 0.31 to 2.73), or PGY 4 (0.80; 0.31 to 2.04) groups. The interaction between PGY and Cormack–Lehane view was significant (-interaction<0.001). In patients with Cormack–Lehane grade 3 or 4, the aORs for first-attempt success were higher for PGY 2 (1.80; 95% CI 1.17 to 2.77), PGY 3 (2.96; 1.66 to 5.27) and PGY 4 (3.10; 1.60 to 6.00) groups relative to PGY 1. Compared with PGY 1, PGY 2, 3, and 4 resident physicians obtained similar Cormack–Lehane views but had higher first-attempt success when obtaining a grade 3 or 4 view.

中文翻译：

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急诊医学研究生年、喉镜视图和气管插管成功率


之前的研究发现，急诊医学 (EM) 研究生年 (PGY) 可以提高首次尝试的成功率。然而，PGY 与喉镜视图（成功插管的关键步骤）之间的关联尚不清楚。我们检查了 PGY、喉镜视图（即 Cormack-Lehane 视图）和首次尝试成功之间的关系。我们对国家紧急气道登记处进行了回顾性分析，包括 EM PGY 1 至 4 名住院医师的成人插管。我们使用逆概率加权和倾向得分来平衡混杂因素。我们使用加权回归和模型比较来估计 PGY 和 Cormack-Lehane 观点之间具有 95% 置信区间 (CI) 的调整优势比 (aOR)，测试 PGY 和 Cormack-Lehane 观点之间关于首次尝试成功的交互作用，并检查Cormack-Lehane 观点对 PGY 与首次尝试成功之间关系的影响修正。排除后，我们纳入了 15,453 次首次尝试。与 PGY 1 相比，较高 Cormack-Lehane 等级的 aOR 与 PGY 2（1.01；95% CI 0.49 至 2.07）、PGY 3（0.92；0.31 至 2.73）或 PGY 4（0.80；0.31 至 2.04）没有差异。 ）组。 PGY 和 Cormack-Lehane 观点之间的交互作用显着（-交互作用<0.001）。在 Cormack-Lehane 3 级或 4 级患者中，PGY 2 首次尝试成功的 aOR 较高（1.80；95% CI 1.17 至 2.77）、PGY 3（2.96；1.66 至 5.27）和 PGY 4（3.10；1.60）至 6.00) 组相对于 PGY 1。与 PGY 1 相比，PGY 2、3 和 4 住院医师获得了类似的 Cormack-Lehane 视图，但在获得 3 级或 4 级视图时具有更高的首次尝试成功率。