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.
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 traumapatients 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: Peep Talving; Pedro G R Teixeira; Galinos Barmparas; Joseph DuBose; Kenji Inaba; Lydia Lam; Demetrios Demetriades Journal: World J Surg Date: 2009-11 Impact factor: 3.352
Authors: Samuel M Galvagno; Elliott R Haut; S Nabeel Zafar; Michael G Millin; David T Efron; George J Koenig; Susan P Baker; Stephen M Bowman; Peter J Pronovost; Adil H Haider Journal: JAMA Date: 2012-04-18 Impact factor: 56.272
Authors: Lasse Raatiniemi; Janne Liisanantti; Suvi Niemi; Heini Nal; Pasi Ohtonen; Harri Antikainen; Matti Martikainen; Seppo Alahuhta Journal: Scand J Trauma Resusc Emerg Med Date: 2015-11-05 Impact factor: 2.953