title: Injury mortality following the loss of air medical support for rural interhospital transport.
abstract: OBJECTIVE
  This study evaluated variation in mortality among interfacility transfers three years before and after discontinuation of a rotor-wing transport service.
  
  
  METHODS
  A retrospective cohort assessment was conducted among severely injured patients transferred from four rural hospitals to a single tertiary center in regions with continued versus discontinued rotor-wing service. Thirty-day mortality following discharge from the receiving tertiary facility served as the primary outcome measure.
  
  
  RESULTS
  Discontinuation of rotor-wing transport decreased interfacility transfers and increased transfer time. Transferred patients were four times more likely to die after (compared with before) rotor-wing service was discontinued (p = 0.05). No difference was noted in the region with continued rotor-wing service [odds ratio (OR) = 0.53, p = 0.47].
  
  
  CONCLUSIONS
  Injury mortality increased with loss of air transport for interfacility transfer in a rural area.
authors.affiliation: Intermountain Injury Control Research Center, University of Utah, School of Medicine, Salt Lake City, UT 84108, USA. clay.mann@hsc.utah.edu
authors.forename: N Clay
authors.initials: NC
authors.lastname: Mann
authors.forename: Kerrie A
authors.initials: KA
authors.lastname: Pinkney
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Price
authors.forename: Donna
authors.initials: D
authors.lastname: Rowland
authors.forename: Melanie
authors.initials: M
authors.lastname: Arthur
authors.forename: Jerris R
authors.initials: JR
authors.lastname: Hedges
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Mullins
mesh_terms: D000293:Adolescent; D000328:Adult; D017732:Air Ambulances / Q000600:supply & distribution*; D015331:Cohort Studies; D005260:Female; D006271:Health Facility Closure; D006780:Hospitals, Rural / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010360:Patient Transfer / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies; D013997:Time Factors; D014187:Transportation of Patients / Q000379:methods / Q000592:standards*; D015599:Trauma Severity Indices; D014481:United States; D014947:Wounds and Injuries / Q000145:classification / Q000401:mortality* / Q000628:therapy*