title: Outcomes of blunt trauma victims transported by HEMS from rural and urban scenes.
abstract: OBJECTIVE
  Mortality differences exist between victims of urban and rural trauma; however, it is unknown if these differences persist in those patients who survive to HEMS transport. This study examined the in-hospital mortality, length of hospital stay, and discharge status of adult blunt trauma victims transported by HEMS from rural and urban scenes to regional trauma centers.
  
  
  METHODS
  Retrospective review of all adult (age >/= 15) HEMS transports in 2001; 271 urban and 141 rural blunt trauma patients were identified from HEMS transport records and the trauma registries at three level one trauma centers. Demographic data, scene and hospital interventions, as well as discharge status of the two groups were examined.
  
  
  RESULTS
  Total mileage [27 +/- 12 vs. 119 +/- 64, p < 0.001], total flight times (minutes) [30 +/- 10 vs. 79 +/- 40, p < 0.001], and scene times (minutes) [16 +/- 8 vs. 21 +/- 14, p < 0.001] were significantly longer for rural flights. There were no significant differences between the groups with regard to age, gender, receiving hospital, and initial HEMS vitals. Injury Severity Score, ICU length of stay (LOS), total hospital LOS, and hospital mortality did not differ between the two groups. After controlling for age, gender, and ISS, there were no significant mortality differences between the two groups (p = 0.074).
  
  
  CONCLUSIONS
  Despite longer flight and scene times for rural patients, adjusted in-hospital mortality rates were similar for patients transported from urban and rural scenes. Factors prior to HEMS arrival may contribute to increased mortality rates of rural blunt trauma victims documented nationally.
authors: Emergency Department Clinical Operations, University Health Care, University of Utah School of Medicine, Salt Lake City, UT, USA. Christy.mccowan@hsc.utah.edu
authors: Christy L
authors: CL
authors: McCowan
authors: Eric R
authors: ER
authors: Swanson
authors: Frank
authors: F
authors: Thomas
authors: Diana L
authors: DL
authors: Handrahan
mesh_terms: D000328:Adult; D017732:Air Ambulances / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000639:trends*; D012042:Registries; D012189:Retrospective Studies; D012424:Rural Population; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D014949:Wounds, Nonpenetrating / Q000401:mortality*