Traumatic brain injury patients frequently undergo tracheal intubation.

We aimed to assess current intubationpractice in Europe and identify variation in practice.

We analysed data from patients with traumatic brain injuryincluded in the prospective cohort study collaborative European neurotrauma effectiveness research intraumatic brain injury (CENTER-TBI) in 45 centres in 16 European countries.

We included patients who weretransported to hospital by emergency medical services.

We used mixed-effects multinomial regression toquantify the effects on pre-hospital or in-hospital tracheal intubation of the following: patient characteristics;injury characteristics; centre; and trauma system characteristics.

A total of 3843 patients were included. Ofthese, 1322 (34%) had their tracheas intubated; 839 (22%) pre-hospital and 483 (13%) in-hospital. Thefit of themodel with only patient characteristics predicting intubation was good (Nagelkerke R2 64%).