Helicopters and the civilian trauma system: national utilization patterns demonstrate improved outcomes after traumatic injury.
BACKGROUND
The role of helicopter transport (HT) in civilian trauma care remains controversial. The objective of this study was to compare patient outcomes after transport from the scene of injury by HT and ground transport using a national patient sample.


METHODS
Patients transported from the scene of injury by HT or ground transport in 2007 were identified using the National Trauma Databank version 8. Injury severity, utilization of hospital resources, and outcomes were compared. Stepwise logistic regression was used to determine whether transport modality was a predictor of survival or discharge to home after adjusting for covariates.


RESULTS
There were 258,387 patients transported by helicopter (16%) or ground (84%). Mean Injury Severity Score was higher in HT patients (15.9 ± 12.3 vs. 10.2 ± 9.5, p < 0.01), as was the percentage of patients with Injury Severity Score >15 (42.6% vs. 20.8%; odds ratio [OR], 2.83; 95% confidence interval [CI], 2.76-2.89). HT patients had higher rates of intensive care unit admission (43.5% vs. 22.9%; OR, 2.58; 95% CI, 2.53-2.64) and mechanical ventilation (20.8% vs. 7.4%; OR, 3.30; 95% CI, 3.21-3.40). HT was a predictor of survival (OR, 1.22; 95% CI, 1.17-1.27) and discharge to home (OR, 1.05; 95% CI, 1.02-1.07) after adjustment for covariates.


CONCLUSIONS
Trauma patients transported by helicopter were more severely injured, had longer transport times, and required more hospital resources than those transported by ground. Despite this, HT patients were more likely to survive and were more likely to be discharged home after treatment when compared with those transported by ground. Despite concerns regarding helicopter utilization in the civilian setting, this study shows that HT has merit and impacts outcome.
Department of Surgery, University of Rochester School of Medicine, Rochester, New York 14642-8410, USA.
Joshua B
JB
Brown
Nicole A
NA
Stassen
Paul E
PE
Bankey
Ayodele T
AT
Sangosanya
Julius D
JD
Cheng
Mark L
ML
Gestring
D000328:Adult; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000401:Aircraft; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D015996:Survival Rate; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D014193:Trauma Centers; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy