A critical analysis of on-scene helicopter transport on survival in a statewide trauma system.
BACKGROUND
Recently, questions have been raised regarding the effectiveness of helicopters in trauma care. We conducted a retrospective study to evaluate the effect of on-scene helicopter transport on survival after trauma in a statewide trauma system.


METHODS
Data were obtained from a statewide trauma registry of 162,730 patients treated at 28 accredited trauma centers. Patients transported from the scene by helicopter (15,938) were compared with those transported by ground with advanced life support (ALS) (6,473). Interhospital transfers and transports without ALS were excluded. Statistical analysis was performed using one-way analysis of variance and logistic regression.


RESULTS
Patients transported by helicopter were significantly (p < 0.01) younger, were more seriously injured, and had lower blood pressure. They were also more likely to be male and to have systolic blood pressure < 90 mm Hg. Logistic regression analysis revealed that when adjusting for other risk factors, transportation by helicopter did not affect the estimated odds of survival.


CONCLUSIONS
A reappraisal of the cost-effectiveness of helicopter triage and transport criteria, when access to ground ALS squads is available, may be warranted.
Crozer-Chester Medical Center, Upland, Pennsylvania 19013-3995, USA.
C E
CE
Brathwaite
M
M
Rosko
R
R
McDowell
J
J
Gallagher
J
J
Proenca
M A
MA
Spott
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D000401:Aircraft; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality*; D010414:Pennsylvania; D012189:Retrospective Studies; D016019:Survival Analysis; D014187:Transportation of Patients / Q000191:economics / Q000706:statistics & numerical data*; D014193:Trauma Centers / Q000706:statistics & numerical data