title: Does Mode of Transport Confer a Mortality Benefit in Trauma Patients? Characteristics and Outcomes at an Ontario Lead Trauma Hospital.
abstract: OBJECTIVE
  Evidence-based guidelines regarding the optimal mode of transport for trauma patients from scene to trauma centre are lacking. The purpose of this study was to investigate the relationship between trauma patient outcomes and mode of transport at a single Ontario Level I Trauma Centre, and specifically to investigate if the mode of transport confers a mortality benefit.
  
  
  METHODS
  A historical, observational cohort study was undertaken to compare rotor-wing and ground transported patients. Captured data included demographics, injury severity, temporal and mortality variables. TRISS-L analysis was performed to examine mortality outcomes.
  
  
  RESULTS
  387 rotor-wing transport and 2,759 ground transport patients were analyzed over an 18-year period. Rotor-wing patients were younger, had a higher Injury Severity Score, and had longer prehospital transport times. Mechanism of injury was similarly distributed between groups. After controlling for heterogeneity with TRISS-L analysis, the mortality of rotor-wing patients was found to be lower than predicted mortality, whereas the converse was found with ground patients.
  
  
  CONCLUSIONS
  Rotor-wing and ground transported trauma patients represent heterogeneous populations. Accounting for these differences, rotor-wing patients were found to outperform their predicted mortality, whereas ground patients underperformed predictions.
authors.affiliation: *Division of Emergency Medicine,McMaster University,Hamilton,ON.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Buchanan
authors.affiliation: †Trauma Program,Hamilton General Hospital,Hamilton,ON.
authors.forename: Angela
authors.initials: A
authors.lastname: Coates
authors.affiliation: †Trauma Program,Hamilton General Hospital,Hamilton,ON.
authors.forename: Niv
authors.initials: N
authors.lastname: Sne
mesh_terms: D000328:Adult; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000552:Ambulances / Q000706:statistics & numerical data*; D002423:Cause of Death; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004632:Emergency Medical Services / Q000458:organization & administration; D005260:Female; D006769:Hospitals, General; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011237:Predictive Value of Tests; D012042:Registries; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014187:Transportation of Patients / Q000379:methods*; D014193:Trauma Centers / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy
keywords: TRISS; helicopter; rotor-wing; scene; transport; trauma