Association between helicopter vs ground emergency medical services and survival for adults with major trauma

Samuel M. Galvagno, Elliott Haut, S. Nabeel Zafar, Michael Millin, David Thomas Efron, George J. Koenig, Susan P. Baker, Stephen M. Bowman, Peter J. Pronovost, Adil H. Haider

Research output: Contribution to journalArticle

Abstract

Context: Helicopter emergency medical services and their possible effect on outcomes for traumatically injured patients remain a subject of debate. Because helicopter services are a limited and expensive resource, a methodologically rigorous investigation of its effectiveness compared with ground emergency medical services is warranted. Objective: To assess the association between the use of helicopter vs ground services and survival among adults with serious traumatic injuries. Design, Setting, and Participants Retrospective cohort study involving 223 475 patients older than 15 years, having an injury severity score higher than 15, and sustaining blunt or penetrating trauma that required transport to US level I or II trauma centers and whose data were recorded in the 2007-2009 versions of the American College of Surgeons National Trauma Data Bank. Interventions Transport by helicopter or ground emergency services to level I or level II trauma centers. Main Outcome Measures: Survival to hospital discharge and discharge disposition. Results A total of 61 909 patients were transported by helicopter and 161 566 patients were transported by ground. Overall, 7813 patients (12.6%) transported by helicopter died compared with 17 775 patients (11%) transported by ground services. Before propensity score matching, patients transported by helicopter to level I and level II trauma centers had higher Injury Severity Scores. In the propensity score-matched multivariable regression model, for patients transported to level I trauma centers, helicopter transport was associated with an improved odds of survival compared with ground transport (odds ratio [OR], 1.16; 95% CI, 1.14-1.17; P

Original languageEnglish (US)
Pages (from-to)1602-1610
Number of pages9
JournalJournal of the American Medical Association
Volume307
Issue number15
DOIs
Publication statusPublished - Apr 18 2012

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ASJC Scopus subject areas

  • Medicine(all)

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