BACKGROUND: Helicopter transport (HT) is frequently used for interfacility transfer of injured patients to a trauma center. The benefits of HT over ground transport (GT) in this setting are unclear. By using a national sample, the objective of this study was to assess whether HT impacted outcomes following interfacility transfer of trauma patients. METHODS: Patients transferred by HT or GT in 2007 were identified using the National Trauma Databank (version 8). Injury severity, resource utilization, and survival to discharge were compared. Stepwise logistic regression was used to determine whether transport modality was a predictor of survival after adjusting for covariates. Regression analysis was repeated in subgroups with Injury Severity Score (ISS)≤15 and ISS>15. RESULTS: There were 74,779 patients transported by helicopter (20%) or ground (80%). Mean ISS was higher in patients transported by helicopter (17±11 vs. 12±9; p<0.01) as was the proportion with ISS>15 (49% vs. 28%; odds ratio [OR], 2.53; 95% confidence interval [CI], 2.43-2.63). Patients transported by helicopter had higher rates of intensive care unit admission (54% vs. 29%; OR, 2.86; 95% CI, 2.75-2.96), had shorter transport time (61±55 minutes vs. 98±71 minutes; p<0.01), and had shorter overall prehospital time (135±86 minutes vs. 202±132 minutes; p<0.01). HT was not a predictor of survival overall or in patients with ISS≤15. In patients with ISS>15, HT was a predictor of survival (OR, 1.09; 95% CI, 1.02-1.17; p=0.01). CONCLUSIONS: Patients transported by helicopter were more severely injured and required more hospital resources than patients transported by ground. HT offered shorter transport and overall prehospital times. For patients with ISS>15, HT was a predictor of survival. These findings should be considered when developing interfacility transfer policies for patients with severe injuries.
BACKGROUND: Helicopter transport (HT) is frequently used for interfacility transfer of injured patients to a trauma center. The benefits of HT over ground transport (GT) in this setting are unclear. By using a national sample, the objective of this study was to assess whether HT impacted outcomes following interfacility transfer of traumapatients. METHODS:Patients transferred by HT or GT in 2007 were identified using the National Trauma Databank (version 8). Injury severity, resource utilization, and survival to discharge were compared. Stepwise logistic regression was used to determine whether transport modality was a predictor of survival after adjusting for covariates. Regression analysis was repeated in subgroups with Injury Severity Score (ISS)≤15 and ISS>15. RESULTS: There were 74,779 patients transported by helicopter (20%) or ground (80%). Mean ISS was higher in patients transported by helicopter (17±11 vs. 12±9; p<0.01) as was the proportion with ISS>15 (49% vs. 28%; odds ratio [OR], 2.53; 95% confidence interval [CI], 2.43-2.63). Patients transported by helicopter had higher rates of intensive care unit admission (54% vs. 29%; OR, 2.86; 95% CI, 2.75-2.96), had shorter transport time (61±55 minutes vs. 98±71 minutes; p<0.01), and had shorter overall prehospital time (135±86 minutes vs. 202±132 minutes; p<0.01). HT was not a predictor of survival overall or in patients with ISS≤15. In patients with ISS>15, HT was a predictor of survival (OR, 1.09; 95% CI, 1.02-1.17; p=0.01). CONCLUSIONS:Patients transported by helicopter were more severely injured and required more hospital resources than patients transported by ground. HT offered shorter transport and overall prehospital times. For patients with ISS>15, HT was a predictor of survival. These findings should be considered when developing interfacility transfer policies for patients with severe injuries.
Authors: Joshua B Brown; Jason L Sperry; Anisleidy Fombona; Timothy R Billiar; Andrew B Peitzman; Francis X Guyette Journal: J Am Coll Surg Date: 2015-01-24 Impact factor: 6.113
Authors: Joshua B Brown; Matthew R Rosengart; Timothy R Billiar; Andrew B Peitzman; Jason L Sperry Journal: J Trauma Acute Care Surg Date: 2017-07 Impact factor: 3.313
Authors: Joshua B Brown; Mark L Gestring; Nicole A Stassen; Raquel M Forsythe; Timothy R Billiar; Andrew B Peitzman; Jason L Sperry Journal: Ann Surg Date: 2016-02 Impact factor: 12.969
Authors: Joshua B Brown; Mitchell J Cohen; Joseph P Minei; Ronald V Maier; Michaela A West; Timothy R Billiar; Andrew B Peitzman; Ernest E Moore; Joseph Cuschieri; Jason L Sperry Journal: Ann Surg Date: 2015-05 Impact factor: 12.969
Authors: Joshua B Brown; Mark L Gestring; Francis X Guyette; Matthew R Rosengart; Nicole A Stassen; Raquel M Forsythe; Timothy R Billiar; Andrew B Peitzman; Jason L Sperry Journal: J Trauma Acute Care Surg Date: 2017-02 Impact factor: 3.313
Authors: Joshua B Brown; Christine M Leeper; Jason L Sperry; Andrew B Peitzman; Timothy R Billiar; Barbara A Gaines; Mark L Gestring Journal: J Trauma Acute Care Surg Date: 2016-05 Impact factor: 3.313
Authors: Joshua B Brown; Mark L Gestring; Francis X Guyette; Matthew R Rosengart; Nicole A Stassen; Raquel M Forsythe; Timothy R Billiar; Andrew B Peitzman; Jason L Sperry Journal: Surgery Date: 2015-10-23 Impact factor: 3.982
Authors: Brian P Walcott; Jean-Valery Coumans; Matthew K Mian; Brian V Nahed; Kristopher T Kahle Journal: PLoS One Date: 2011-10-12 Impact factor: 3.240