title: Quality of life following trauma before and after implementation of a physician-staffed helicopter.
abstract: BACKGROUND
  Implementation of a physician-staffed helicopter emergency medical service (PS-HEMS) in Denmark was associated with lower 30-day mortality in severely injured trauma patients and less time on social subsidy. However, the reduced 30-day mortality in severely injured patients might be at the expense of a worse functional outcome and quality of life (QoL) in those who survive. The aim of this study was to investigate the effect of a physician-staffed helicopter on long-term QoL in trauma patients.
  
  
  METHODS
  Prospective, observational study including trauma patients who survived at least 3 years after injury. A 5-month period prior to PS-HEMS implementation was compared with the first 12 months after PS-HEMS implementation. QoL was assessed 4.5 years after trauma by the SF-36 questionnaire. Primary endpoint was the Physical Component Summary score.
  
  
  RESULTS
  Of the 1994 patients assessed by a trauma team, 1521 were eligible for inclusion in the study. Of these, 566 (37%) gave consent to participate and received a questionnaire by mail, and 402 (71%) of them returned the questionnaire (n = 114 before PS-HEMS; n = 288 after PS-HEMS implementation). Older patients, women and patients with trauma in the after PS-HEMS period were more likely to return the questionnaire. No significant association between QoL and period (before vs. after PS-HEMS) was found; the Physical Component Summary scores were 50.0 and 50.9 in the before and after PS-HEMS periods, respectively (P = 0.47). We also found no difference on multivariable analysis with adjustment for sex, age and injury severity score.
  
  
  CONCLUSIONS
  No significant difference in QoL among trauma patients was found after implementation of a PS-HEMS.
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: K S
authors.initials: KS
authors.lastname: Funder
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: L S
authors.initials: LS
authors.lastname: Rasmussen
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Hesselfeldt
authors.affiliation: The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: V
authors.initials: V
authors.lastname: Siersma
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Lohse
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Sonne
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Wulffeld
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Steinmetz
mesh_terms: D000328:Adult; D017732:Air Ambulances; D000401:Aircraft; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011446:Prospective Studies; D011788:Quality of Life; D014947:Wounds and Injuries / Q000401:mortality / Q000523:psychology*