Air Transport Ups Survival Despite Severity of Trauma
Helicopter transport has survival benefit over ground transport for trauma, despite injury severity
TUESDAY, June 25 (HealthDay News) -- Trauma patients transported via helicopter emergency medical services (HEMS) have improved survival compared to those transported via ground emergency medical services (GEMS), despite tending to be more seriously injured, according to a study published online June 21 in Critical Care.
Hagen Andruszkow, M.D., from University Hospital Aachen in Germany, and colleagues used the German Society for Trauma Surgery's TraumaRegister DGU to analyze data from 13,220 trauma patients (injury severity score [ISS], ≥9) transported by HEMS or GEMS to level I and II trauma centers from 2007 to 2009.
The researchers found that 62.3 percent (8,231 patients) were transported by GEMS and 37.7 percent (4,989 patients) by HEMS. Those transported by HEMS were significantly more seriously injured compared to GEMS (ISS, 26.0 versus 23.7), with more severe chest and abdominal injuries. HEMS-treated patients also involved more extensive on-scene medical treatment, including intubation and treatment with vasopressors, resulting in a significantly prolonged on-scene time (39.5 versus 28.9 minutes). HEMS patients had a significantly increased length of intensive care unit stay and in-hospital time due to more frequent development of multiple organ dysfunction syndrome (HEMS, 33.4 percent; GEMS, 25.0 percent) and sepsis (HEMS, 8.9 percent; GEMS, 6.6 percent). The odds ratio for mortality in HEMS was 0.75, after adjusting for other variables.
"Although HEMS patients were more seriously injured and had a significantly higher incidence of multiple organ dysfunction syndrome and sepsis, these patients demonstrated a survival benefit compared to GEMS," the authors write.
Research funding was provided by Deutsche Rettungsflugwacht (German Air Rescue).
Abstract (http://ccforum.com/content/17/3/R124/abstract )Full Text (http://ccforum.com/content/pdf/cc12796.pdf )