Helicopter Transport of Trauma Patients Improves Survival Irrespective of Transport Time

• Published in: The American surgeon Vol. 87; no. 4; pp. 538 - 542
• Main Authors: Schneider, Andrew M., Ewing, Joseph A., Cull, John D.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.04.2021; SAGE PUBLICATIONS, INC
• Subjects: Adult; Age; Air Ambulances; Air transportation; Aircraft; Aircraft accidents; Ambulances; Burns; Demographics; Demography; Female; Gender; Helicopters; Humans; Injuries; Injury Severity Score; Intubation; Male; Middle Aged; Mortality; Patients; Regression analysis; Retrospective Studies; Survival; Survival Rate; Time Factors; Trauma; Trauma centers; Wounds and Injuries - mortality; United States > US; trauma; helicopter; survival
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/0003134820943564

Objectives Helicopter transport of trauma patients remains controversial. We examined the survival rates of patients undergoing helicopter versus ground transport to a Level 1 trauma center. Methods Retrospective analysis was performed on trauma patients treated between 2014 and 2017. Student’s t-test was used to compare air versus ground transport times. A logistic regression was then used to examine the association of transportation type on survival controlling for demographics, mechanism of injury, transport time, field intubation, and injury severity. Results Of 3967 patients identified, 69.6% (2762) were male, and the average age was 40 years. Most patients suffered blunt injuries (86.8%, 3445), while the remaining had penetrating injuries (11.6%, 459) or burns (1.6%, 63). The majority of patients were transferred by ground (3449) with only 13% (518) transferred by air. Patients transported by air had increased Injury Severity Score (ISS) with a median of 17 (IQR 9-24) versus 9 (IQR 5-14), increased length of stay (LOS) at 6 days versus 3 (P < .001), and increased mortality at 12.6% vs 6.5% (P < .001). Patients transported by air arrived 16.6 ± 6.7 minutes faster compared with ground for the zip codes examined. When adjusting for the mechanism of injury, ISS, age, gender, intubation status, and transport time, air transport was associated with an increased likelihood of survival (odds ratio [OR] = 1.57, 95% CI = 1.06-2.40). Conclusion In our analysis of 3967 patients, those transported by air had a significant improvement in the likelihood of survival compared with those transported by ground even when adjusting for both ISS and time.