In cases of severe trauma, helicopter transport to a top-level center increases the patient’s chance of survival over ground transport, according to a study of more than 220,000 cases.
“We looked at the sickest patients with the most severe injuries and applied sophisticated statistical analyses to the largest aggregation of trauma data in the world,” study leader Samuel M. Galvagno Jr., DO, PhD, stated in a University of Maryland Medical Center news release. “We were careful at every step to balance all the potential other factors that could explain any benefit of the helicopter. After all that, the survival advantage of helicopters remained.”
For the study, published recently in the Journal of the American Medical Association, Galvagno and his team reviewed 223,475 cases from the American College of Surgeons National Trauma Data Bank involving patients older than 15 years with an injury severity score greater than 15. Patients sustained either blunt or penetrating trauma, requiring transport to level I or II trauma centers.
According to the study abstract, 61,909 patients were transported by helicopter while 161,566 patients received ground transport. The review showed 7,813 patients (12.6%) died during helicopter transport, while 17,775 patients (11%) died during ground transport. Patients who received helicopter transport to level I and level II trauma centers were reported to have higher Injury Severity Scores prior to propensity score matching. Following score matching, helicopter transport for those patients was found to improve odds of survival.
The authors found that 18.2% of patients who received helicopter transport to a level I trauma center were eventually discharged to rehabilitation compared with 12.7% of patients who received ground transport, according to the study abstract. Further, 9.3% of patients transported via helicopter were discharged to intermediate facilities compared with 6.5% of patients transported by ground.
“The benefits of the helicopter, we believe, are related to multiple factors,” Galvagno stated in the release. “Certainly time and crew expertise play a role. Beyond that, we’re not sure. More study is warranted.”
- Galvagno Jr. SM, Haut ER, Zafar SN, et al. Association between helicopter vs. ground emergency medical services and survival for adults with major trauma. J Am Med Assoc. 2012. doi: 10.1001/jama.2012.467