Air medical transport of the injured patient: scene versus referring hospital.
BACKGROUND
In a rural service area, does the outcome of air medical patients transferred from the scene of injury differ from that of patients transferred from a primary receiving hospital?


METHODS
Retrospective review of all injured patients transported by air to a single trauma center during calendar year 1996. Data collected include basic patient demographics, time of injury, revised trauma score (RTS), injury severity score (ISS), probability of survival (PS), hospital length of stay (LOS), complications, disposition, and mortality.


RESULTS
Concerning trauma admission, 594 of 1461 (40.7%) were transported by air: 363 from the scene (24.9%) and 231 from referring hospitals (15.8%). These two groups were similar in demographics, injury severity, hospital LOS, and crude mortality: RTS, 6.61 versus 6.68 (P > 0.05); ISS, 16.0 versus 16.0 (P > 0.05); LOS = 6.9 days versus 7.3 days (P > 0.05); mortality = 11.8% versus 10.8% (P > 0.05). The groups differed significantly, however, in time from injury to definitive care (34.2 minutes versus 196.2 minutes, P < 0.001), overall complication rate (39.1% versus 57.6%, P = 0.009), and potentially preventable deaths (PS > 0.5, 11.6% versus 44%, P = 0.02).


CONCLUSIONS
Patient groups were similar, suggesting similar triage criteria. Patients transferred from a referring hospital took almost six times longer to reach definitive care and may have suffered an increased morbidity and mortality on this basis.
Falcone
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Grant Medical Center, Columbus, OH 43215, USA.
Herron
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Werman
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Bonta
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D000328:Adult; D017732:Air Ambulances / Q000458:organization & administration* / Q000706:statistics & numerical data; D003625:Data Collection; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D009820:Ohio; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D018024:Peer Review, Health Care; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration*; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*