Literature DB >> 17219188

[The influence of transportation mode on mortality in polytraumatized patients. An analysis based on the German Trauma Registry].

M Frink1, C Probst, F Hildebrand, M Richter, C Hausmanninger, B Wiese, C Krettek, H-C Pape.   

Abstract

BACKGROUND: Thirty years after its introduction in Germany, the benefits of the helicopter emergency medical service (HEMS) compared to ground ambulances (GA) still remain unclear. The aim of this study was to evaluate the influence of helicopter transport on rescue time and mortality based on the data of the German Trauma Registry.
METHODS: Data from patients with multiple injuries were documented prospectively between 1993 and 2003 in different trauma centers in Germany, Switzerland, Austria and The Netherlands. From these data, patients with an injury severity score (ISS)<16 were excluded. Patients who were transported to the hospital without a physician were also excluded. The data from included patients were evaluated for time to hospital and influence of transportation service on mortality.
RESULTS: A total of 7,534 patients with multiple injuries were included. Of these, 3,870 patients were transported by HEMS and 3,664 reached the hospital by GA. There were 74.9% male patients in the HEMS group, and 71.3% male patients in the GA group. The mean ISS was higher in the HEMS group (31.4 vs 30.7; P<0.01); patients transported by GA were older (HEMS: 39.2; NEF:41.3; P<0.01). The GA arrived on the scene after 14.33 min, the HEMS after 18.18 min (P<0.01). Time at the scene was longer in the HEMS group (HEMS: 26:26 min; NEF: 22:29 min; P<0.01). Intubation rate in the HEMS group was about 80%, while patients transported by GA were intubated in 60% of cases. The overall mortality was 30.9%. Evaluation of the TRISS prediction of survival showed a benefit for patients transported with HEMS. In a multivariate analysis, intubated patients with ISS<or=60 had a lower mortality rate if transported with HEMS (NEF: 40.1%; HEMS 34.9%; P<0.01).
CONCLUSIONS: Only minor differences in age and ISS were found between the groups. The time between the accident and arrival of the physician was longer in the HEMS group. The HEMS group also remained on the scene for longer, but had a higher rate of intervention. According to our analysis of the German Trauma Registry, patients with multiple injuries benefit from HEMS transportation.

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Year:  2007        PMID: 17219188     DOI: 10.1007/s00113-006-1222-2

Source DB:  PubMed          Journal:  Unfallchirurg        ISSN: 0177-5537            Impact factor:   1.000


  20 in total

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Authors:  E Garthe; J D States; N K Mango
Journal:  J Trauma       Date:  1999-08

2.  The cost and effectiveness of the London Helicopter Emergency Medical Service.

Authors:  J Brazier; J Nicholl; H Snooks
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3.  Is 30 minutes the golden period to perform emergency room thoratomy (ERT) in penetrating chest injuries?

Authors:  E E Frezza; H Mezghebe
Journal:  J Cardiovasc Surg (Torino)       Date:  1999-02       Impact factor: 1.888

4.  Injury-associated hypothermia: an analysis of the 2004 National Trauma Data Bank.

Authors:  R Shayn Martin; Patrick D Kilgo; Preston R Miller; J Jason Hoth; J Wayne Meredith; Michael C Chang
Journal:  Shock       Date:  2005-08       Impact factor: 3.454

5.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.

Authors:  S P Baker; B O'Neill; W Haddon; W B Long
Journal:  J Trauma       Date:  1974-03

6.  Effects of 2 patterns of prehospital care on the outcome of patients with severe head injury.

Authors:  S Di Bartolomeo; G Sanson; G Nardi; F Scian; V Michelutto; L Lattuada
Journal:  Arch Surg       Date:  2001-11

7.  Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes.

Authors:  John R Clarke; Stanley Z Trooskin; Prashant J Doshi; Lloyd Greenwald; Charles J Mode
Journal:  J Trauma       Date:  2002-03

8.  Differences in mortality rates among trauma patients transported by helicopter and ambulance in Maryland.

Authors:  W A Kerr; T J Kerns; R A Bissell
Journal:  Prehosp Disaster Med       Date:  1999 Jul-Sep       Impact factor: 2.040

9.  Paramedic helicopter emergency service in rural Finland - do benefits justify the cost?

Authors:  J Kurola; M Wangel; A Uusaro; E Ruokonen
Journal:  Acta Anaesthesiol Scand       Date:  2002-08       Impact factor: 2.105

10.  A critical analysis of on-scene helicopter transport on survival in a statewide trauma system.

Authors:  C E Brathwaite; M Rosko; R McDowell; J Gallagher; J Proenca; M A Spott
Journal:  J Trauma       Date:  1998-07
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  18 in total

1.  [Importance of air ambulances for the care of the severely injured].

Authors:  U Schweigkofler; C Reimertz; R Lefering; R Hoffmann
Journal:  Unfallchirurg       Date:  2015-03       Impact factor: 1.000

2.  Trauma-related preventable deaths in Berlin 2010: need to change prehospital management strategies and trauma management education.

Authors:  C Kleber; M T Giesecke; M Tsokos; N P Haas; C T Buschmann
Journal:  World J Surg       Date:  2013-05       Impact factor: 3.352

3.  [Deployment and efficacy of ground versus helicopter emergency service for severely injured patients. Analysis of a nationwide Swiss trauma center].

Authors:  S Günkel; M König; R Albrecht; M Brüesch; R Lefering; K Sprengel; C M L Werner; H-P Simmen; G A Wanner
Journal:  Unfallchirurg       Date:  2015-03       Impact factor: 1.000

4.  [Rehabilitation of multiple injured patients in Germany: Clinic locations, structural and equipment attributes].

Authors:  F Debus; L Moosdorf; C L Lopez; S Ruchholtz; T Schwarting; C A Kühne
Journal:  Unfallchirurg       Date:  2016-03       Impact factor: 1.000

5.  [On-scene times for helicopter services. Influence of central dispatch center strategy].

Authors:  A Gries; W Lenz; P Stahl; R Spiess; T Luiz
Journal:  Anaesthesist       Date:  2014-06-26       Impact factor: 1.041

6.  [Time intervals during and after emergency room treatment. An analysis using the trauma register of the German Society for Trauma Surgery].

Authors:  S Wutzler; J Westhoff; R Lefering; H L Laurer; H Wyen; I Marzi
Journal:  Unfallchirurg       Date:  2010-01       Impact factor: 1.000

7.  Epidemiological and economic aspects of polytrauma management in Austria.

Authors:  Silke Aldrian; Simon Wernhart; Lukas Negrin; Gabriel Halat; Elisabeth Schwendenwein; Vilmos Vécsei; Stefan Hajdu
Journal:  Wien Klin Wochenschr       Date:  2011-12-05       Impact factor: 1.704

8.  A comparison of the treatment of severe injuries between the former East and West German States.

Authors:  Carsten Mand; Thorben Müller; Rolf Lefering; Steffen Ruchholtz; Christian A Kühne
Journal:  Dtsch Arztebl Int       Date:  2013-03-22       Impact factor: 5.594

9.  [Emergency care for traffic accidents in Bavaria: current process analysis depending on hospital and emergency service structures].

Authors:  C K Lackner; S Bielmeier; K Burghofer
Journal:  Unfallchirurg       Date:  2010-03       Impact factor: 1.000

10.  [Time in care of trauma patients in the air rescue service: implications for disposition?].

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