Kamilia S Funder1, Lars S Rasmussen2, Nicolai Lohse3, Volkert Siersma4, Rasmus Hesselfeldt2, Jacob Steinmetz2. 1. Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: milafun@hotmail.com. 2. Department of Anaesthesia, Centre of Head and Orthopaedics 4231, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 3. Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark. 4. The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Abstract
INTRODUCTION: The first Danish Helicopter Emergency Medical Service (HEMS) was introduced May 1st 2010. The implementation was associated with lower 30-day mortality in severely injured patients. The aim of this study was to assess the long-term effects of HEMS on labour market affiliation and mortality of trauma patients. METHODS: Prospective, observational study with a maximum follow-up time of 4.5 years. Trauma patients from a 5-month period prior to the implementation of HEMS (pre-HEMS) were compared with patients from the first 12 months after implementation (post-HEMS). All analyses were adjusted for sex, age and Injury Severity Score. RESULTS: Of the total 1994 patients, 1790 were eligible for mortality analyses and 1172 (n=297 pre-HEMS and n=875 post-HEMS) for labour market analyses. Incidence rates of involuntary early retirement or death were 2.40 per 100 person-years pre-HEMS and 2.00 post-HEMS; corresponding to a hazard ratio (HR) of 0.72 (95% confidence interval (CI) 0.44-1.17; p=0.18). The HR of involuntary early retirement was 0.79 (95% CI 0.44-1.43; p=0.43). The prevalence of reduced work ability after three years were 21.4% vs. 17.7%, odds ratio (OR)=0.78 (CI 0.53-1.14; p=0.20). The proportions of patients on social transfer payments at least half the time during the three-year period were 30.5% vs. 23.4%, OR=0.68 (CI 0.49-0.96; p=0.03). HR for mortality was 0.92 (CI 0.62-1.35; p=0.66). CONCLUSIONS: The implementation of HEMS was associated with a significant reduction in time on social transfer payments. No significant differences were found in involuntary early retirement rate, long-term mortality, or work ability.
INTRODUCTION: The first Danish Helicopter Emergency Medical Service (HEMS) was introduced May 1st 2010. The implementation was associated with lower 30-day mortality in severely injured patients. The aim of this study was to assess the long-term effects of HEMS on labour market affiliation and mortality of traumapatients. METHODS: Prospective, observational study with a maximum follow-up time of 4.5 years. Traumapatients from a 5-month period prior to the implementation of HEMS (pre-HEMS) were compared with patients from the first 12 months after implementation (post-HEMS). All analyses were adjusted for sex, age and Injury Severity Score. RESULTS: Of the total 1994 patients, 1790 were eligible for mortality analyses and 1172 (n=297 pre-HEMS and n=875 post-HEMS) for labour market analyses. Incidence rates of involuntary early retirement or death were 2.40 per 100 person-years pre-HEMS and 2.00 post-HEMS; corresponding to a hazard ratio (HR) of 0.72 (95% confidence interval (CI) 0.44-1.17; p=0.18). The HR of involuntary early retirement was 0.79 (95% CI 0.44-1.43; p=0.43). The prevalence of reduced work ability after three years were 21.4% vs. 17.7%, odds ratio (OR)=0.78 (CI 0.53-1.14; p=0.20). The proportions of patients on social transfer payments at least half the time during the three-year period were 30.5% vs. 23.4%, OR=0.68 (CI 0.49-0.96; p=0.03). HR for mortality was 0.92 (CI 0.62-1.35; p=0.66). CONCLUSIONS: The implementation of HEMS was associated with a significant reduction in time on social transfer payments. No significant differences were found in involuntary early retirement rate, long-term mortality, or work ability.
Authors: K S Funder; L S Rasmussen; R Hesselfeldt; V Siersma; N Lohse; A Sonne; S Wulffeld; J Steinmetz Journal: Acta Anaesthesiol Scand Date: 2017-01 Impact factor: 2.105
Authors: Scott Munro; Mark Joy; Richard de Coverly; Mark Salmon; Julia Williams; Richard M Lyon Journal: Scand J Trauma Resusc Emerg Med Date: 2018-09-25 Impact factor: 2.953