Objective: Rural U.S. regions have moved to air rather than ground transport for interhospital transfer of injured patients. One Western region discontinued helicopter transport following a crash. We evaluated the temporal variation in death rates among injury-related interhospital transfers associated with discontinuation of helicopter transport. Methods: A pre- versus post- helicopter crash analysis of interhospital injury transfers originating from 4 rural hospitals (region “A”) and 3 rural hospitals (region “B”). Region “A” represents an area with continued helicopter transport versus region “B” which discontinued helicopter transport. Fixed wing transport remained available in both areas. Medical record abstraction for all patients presenting to participating hospitals with head, chest, liver/spleen, or femur/open tibia injuries for three years before and after the crash. Results: A total of 200 helicopter and 141 ground interhospital transfers were documented for the rural regions served. Average median transport time for head injured patients in Region B increased by 1 hour and 2 minutes after loss of helicopter service. In Region B, deaths among transferred head injured patients increased from 6 to 13 after helicopter service cessation. A logistic model controlling for age, AIS and multiple injuries indicates patients who undergo interhospital transfer were 4.8 times more likely to die after ground transport compared to air transport in region “B” (p< .05). No difference in death risk by transportation mode was noted for region “A” with continued helicopter service (p=0.84, OR=1.2). Conclusion: Adverse outcomes were associated with cessation of helicopter transport for interhospital transfer of injured patients. See iicrc.med.utah.edu
Learning Objectives: At conclusion of this session, the participant will be able to: 1. Identify that lack of rotor-wing air transport adversely affects outcomes in moderate to severely injured patients. 2. Recognize that injured patients who undergo ground interhospital transport are 4.8 times more likely to die than helicopter transported patients. 3. Recognize that transport times are critically increased in injured patients when no helicopter service is available.
Keywords: Injury,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.