Helicopter Transport Increases Trauma Patient Survival

Severely injured patients transported by helicopter from the scene of an accident are more likely to survive than patients brought to trauma centers by ground ambulance, according to a new study.

Researchers at the University of Rochester Medical Center (URMC; NY, USA) identified 258,387 patients transported from the scene of injury by helicopter (16%) or ground (84%), during 2007, using the US National Trauma Databank. Injury severity, utilization of hospital resources, and outcomes were compared, and stepwise logistic regression was used to determine whether transport modality was a predictor of survival or discharge to home after adjusting for covariates.

The researchers found that the helicopter-transport patients were younger, more likely to be male, and more likely to be victims of motor vehicle crashes or falls, compared to ground-transport patients. Overall, almost half of the helicopter-transport patients were admitted to the intensive care unit (ICU), with 20% requiring assistance breathing for an average of one week, and close to 20% needing an operation. Trauma patients transported by helicopter were also more severely injured, had longer transport times, and required more hospital resources than those transported by ground. Despite this, they were more likely to survive and were more likely to be discharged home after treatment, when compared with those transported by ground. The study was published in the November 2010 issue of the Journal of Trauma: Injury, Infection, and Critical Care.

"The goal is always to get the sickest people to the trauma center as fast as possible, and our data suggest that's exactly what's happening. We're not seeing helicopters being used to transport trivial cases, which is undoubtedly a poor use of resources,” said lead author Mark Gestring, MD., of the URMC trauma center. "Air medical transport is a valuable resource which can make trauma center care more accessible to patients who would not otherwise be able to reach such centers.”

Previous studies on the use of helicopters to transport injured patients have reported mixed results, but are limited by small patient populations from single institutions or specific regions. Some smaller studies propose helicopters are overused, transporting patients with relatively minor injuries who would fare just as well if they were transported by ground. However, the new national data does not reveal such a trend.

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