You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
several studies comparing emergency physicians ( ep ) skills at intubation with other practitioners , primarily anaesthesiologists , found similar proficiency [ 1 , 2 ] . complications of emergency department ( ed ) intubations have been studied , but most only examine the peri - intubation period .
while there are several studies that provide data as to rates of success of ed intubation and need for cricothyrotomy , there is little information as to the long - term prognosis of these patients .
patients who are intubated in the ed are some of the most critically ill patients in the ed ; the mortality after ed intubation has not been well studied .
previous studies have shown that the lay public have a lack of understanding of the dismal outcomes associated with cardiac arrests .
understanding the outcomes of ed intubation can be useful in discussion with families of patients as well as provide information for future research .
the purpose of this study is to identify the rate of ed intubation and the mortality associated with ed intubation .
we conducted a retrospective chart review for all ed intubations performed over a 1-year period between 1 january 2004 and 31 december 2004 at an urban level one trauma centre with approximately 50,000 ed visits annually .
ed intubations were identified retrospectively by reviewing the hospital financial databases for intubations for all ed patients .
patients that had critical care billing for an intubation procedure or for ventilator use in the ed were obtained .
ed patient logs were also examined to identify all patients who were admitted to the intensive care unit ( icu ) , the operating rooms or died .
patients who were intubated prior to arrival in our ed either by another hospital or by prehospital personnel were excluded from our cohort .
two investigators reviewed all charts and abstracted the following data : age , sex , final disposition from hospital , reason for intubation using a standardized list of terms and trauma versus non - trauma .
if all data were not available from the discharge summary , the original chart was reviewed to gather the necessary data .
de - identified data were entered into a microsoft excel 2003 ( redmond , wa , usa ) database and analysed using stata v8.2 ( college station , tx , usa ) .
confidence intervals were calculated and comparisons were made using unpaired t - tests and fisher s exact tests .
one hundred and sixty - three patients were intubated in our ed during the 1-year study period .
the total 163 patients , 44 ( 27.0% ) died prior to discharge from the hospital , and 72 ( 44.2% ) patients were discharged to home or left against medical advice ( ama ) ( 1 patient ) .
forty - two ( 25.8.% ) patients were discharged to a skilled nursing facility ( e.g. nursing home , rehabilitation and extended care facility ) for further care . dividing this patient population into trauma and non - trauma subgroups ,
6/37 ( 16.2% ) of the trauma patients died and 38/136 ( 30.2% ) of the non - trauma patients died .
the mean age for all patients was 61.3  years , with trauma patients being younger ( 49.0 versus 65.0 ) than the non - trauma subgroup .
the mean age of the survivors was lower than the non - survivors : 57.3 versus 72.2 ( p  <  0.0001 ) .
no children were identified as having been intubated in our study , as our institution does not routinely care for paediatric patients .
table  1age and mortality of patients intubated in the ed  overalltraumanon - trauman16337126age61.3 ( 58.064.7)49.0 ( 40.557.5)64.5 ( 61.768.3)mortality27.0% ( 20.033.9)16.2% ( 4.128.3)30.2% ( 22.238.3)table  2comparison of age of intubated patients survived vs died  alltraumanon - traumasurvivor ( mean age)57.3 ( 53.361.3)44.0 ( 34.953.0)62.0 ( 58.166.0)death ( mean age)72.2 ( 67.476.9)74.8 ( 65.684.0)71.7 ( 66.477.1 ) age and mortality of patients intubated in the ed comparison of age of intubated patients survived vs died of the deaths , 38.6% occurred within 24 h of intubation . an additional 22.7 , 29.5 and 9.1% of deaths occurred at 72 h , 7  days and 30  days , respectively , after intubation . no deaths were found to occur beyond 30  days of hospitalization .
in our search of the literature no large studies reporting mortality after intubation in the ed were found .
the near database , the largest ed airway registry at present , provides insight into the ed course of these patients , but does not collect post - intubation data or outcomes on their patients .
most of the emergency medicine literature concentrates on the mechanics of the intubation and the time surrounding the event .
considerable emergency medicine research focuses on the tools of airway assessment and techniques to improve intubation success such as the lemon score and the burp maneuver [ 5 , 6 ] .
alternatively , there is a lack of information on how these patients do once they leave the ed , and how the various techniques impact on the mortality associated with ed intubation .
while the patients who require ed intubation certainly represent a sicker population , our study demonstrates a relatively high mortality rate .
now that we know the mortality rate of 27% , we can begin to examine those interventions that not only improve the success of ed intubation , but also ultimately improve mortality . as an initial step , we chose to do a retrospective chart review of all ed intubations for a 1-year period .
while recognizing the limitations of such an approach , we thought this initial study would provide some useful information and indications for future research .
the considerable mortality rate following intubation is not surprising as the need for intubation in the ed probably represents a marker for severity of disease . like mortality from sepsis or after a myocardial infarction ,
establishing a baseline mortality rate after ed intubation will provide us with an outcome measure we can use to test the benefit of specific interventions . due to the limited number of patients in our cohort , many questions remain unanswered .
stratification of the patients by disease entity could not be achieved in a meaningful way .
for example , should head injuries be classified as neurological or as traumatic ? the one major subdivision of patients we could perform analysis on was trauma versus non - trauma patients .
this finding could be explained by the lower age of trauma patients and their ability to respond to medical interventions . in both groups ,
this is most evident in the trauma group where the mean age was 44.0  years , but the mean age of those who died was 74.8  years as compared to the non - trauma group .
older patients with myocardial infarction and stroke have been demonstrated to have worse outcomes in the literature [ 7 , 8 ] .
older patients tend to have less physiological reserve so the same insult would be expected to have a greater deleterious effect upon prognosis .
yanagawa et al . , in a study comparing intubation without medications versus with medications for non - traumatic ich , reported the mortality of the two groups as 46.8 and 72.9% , respectively .
the study had 70 patients for their control and study group combined and the main outcome measure was the glasgow outcome score , not mortality . if we select non - traumatic ich from our patients , 9/16 ( 56.2% ) died .
the high mortality rate in the ich subgroup , and the differences in the trauma and non - trauma groups , suggest that with a large enough number of patients subgroup analysis may reveal differences in mortality by specific disease entity .
survival to hospital discharge was chosen over 30-day mortality since it eliminated the problem of having patients that could not be followed up while still providing a meaningful endpoint .
this study was conducted as a pilot study to provide background data as to what directions would be of interest in future studies . as a single - centre retrospective study we are limited in our ability to make general statements based on our study population . as we saw no paediatric patients , we can not make any inferences as to their mortality rate after intubation .
the small sample size limits our ability to provide subgroup analysis for outcomes based on the reason for intubation other than the fairly broad trauma / non - trauma division . since there is no central way to identify patients who were intubated in our ed , we used multiple methods to identify cases ; however , there is a small chance we still could have overlooked a particular group that could alter the outcome .
future studies should attempt to identify predictors of mortality among ed intubations as well as look at this question in a multicentre setting .
introductionthe purpose of this study is to identify the rate of emergency department ( ed ) intubation and the mortality associated with ed intubation.methodswe conducted a retrospective chart review of all patients intubated in the ed between 1 january 2004 and 31 december 2004 at an urban level one trauma centre with approximately 50,000 ed visits annually . 
 all ed intubations were identified and reviewed . 
 two investigators reviewed all charts and collected the following data : age , sex , and final disposition from hospital as well as reason for intubation . 
 the main outcome measure was survival to hospital discharge.resultsone hundred sixty - three intubations were reviewed . of 
 the total 163 patients , 44 ( 27.0% ) died prior to discharge from the hospital , 42 ( 25.8.% ) patients were discharged to a skilled nursing facility ( e.g. nursing home , rehabilitation and extended care facility ) and 71 ( 43.6% ) patients were discharged home . dividing our cohort into trauma and non - trauma subgroups , 38/126 ( 30.2% ) of the non - trauma patients and 6/37 ( 16.2.% ) of the trauma patients died . 
 the mean age for all patients in our study group was 61.5  years , with trauma patients being younger than the non - trauma subgroup . 
 the mean age for trauma patients was 50.1 while non - trauma patients had a mean age of 64.8.conclusionsthe mortality after an ed intubation in our study population was relatively high . 
 further studies need to confirm these findings and help identify predictors of mortality .