Two-year mortality in 760 patients transported by helicopter direct from the road accident scene.

Of 760 direct admissions to a specialized trauma center, 173 (22.7%) victims of motor vehicle accidents died. Excluding patients dead on arrival, the mortality rate was 14.5%. Autopsy reports were reviewed and showed that the major cause of death was head injury (49.7%). Uncontrollable hemorrhage from massive trauma was the next most common problem and usually proved fatal in the first 24 hours after admission. The incidence of sepsis and renal failure increased with prolongation of CCRU stay. Following admission, respiratory failure was not a common cause of death (3%). Because of direct helicopter rather than ambulance transport from the scene of the motor vehicle accident, earlier attention was paid to diagnosis of trauma and treatment of respiratory insufficiency with mechanical ventilation. Because of the early initiation of therapy, there was rapid restoration of circulating volume and tissue perfusion. This may account for the low mortality.