For major trauma, helicopter transport improves survival
HealthDay News -- Patients with major trauma that are transported via helicopter to level I or II trauma centers have an improved chance of surviving compared with those transported by ground emergency medical services, according to a study published in the Journal of the American Medical Association.
"The results from this study indicate that helicopter EMS transport is independently associated with improved odds of survival for seriously injured adults," Samuel M. Galvagno Jr., DO, PhD, of the University of Maryland Medical Center in Baltimore, and colleagues wrote.
They analyzed data from the 2007 to 2009 versions of the American College of Surgeons National Trauma Data Bank. The study cohort included patients older than 15 years with blunt or penetrating injury and an injury severity score higher than 15 that required transport to U.S. level I or II trauma centers. A total of 61,909 patients were transported by helicopter and 161,566 were transported by ground emergency services.
Although patients transported by helicopter had higher Injury Severity Scores and a greater percent died -- 12.6% vs. 11% of ground services patients -- helicopter transport was associated with significantly improved odds for survival among both those transported to level I (odds ratio=1.16; absolute risk reduction=1.5%) and level II (OR= 1.15; ARR=1.4 percent) trauma centers.
Upon discharge, a greater proportion of patients transported by helicopter to level I trauma centers were discharged to rehabilitation compared with those who received ground transportation services (18.2% vs. 12.7%; P<0.001), as was the case with discharge to intermediate facilities (9.3% vs. 6.5%; P <0.001). Furthermore, fewer patients transported by helicopters to level II trauma centers left facilities against medical advice (0.5% vs. 1.0%; P<0.001).
"Additional outcomes besides mortality, such as health-related quality of life, should also be considered in future helicopter EMS transportation studies," the researchers wrote. Because of the high cost of EMS helicopter transportation -- $114,777 to $4 .5 million per institution -- "policy makers should consider funding a formal cost-effectiveness analysis to help inform policy decisions regarding its use."
A limitation of the study included the potential for selection bias, because researchers used a convenience sample that may not have represented all types of hospitals or patients.