Document Detail


Helicopter evacuation of trauma victims in Los Angeles: does it improve survival?
MedLine Citation:
PMID:  19672650     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California.
METHODS: The trauma registry of LAC+USC Medical Center was reviewed to identify all injured patients evacuated by emergency medical service (EMS) from the injury scene from 1998 to 2007. The study population was divided into those who were airlifted (HEMS) and those who were transported by ground emergency medical service (GEMS) with transportation time that exceeded 30 minutes (GEMS > 30 minutes).
RESULTS: During the 10-year study period, 1,836 patients were airlifted (helicopters for emergency medical service (HEMS)) and 1,537 patients were ground transported (GEMS > 30 minutes). HEMS patients suffered more frequently a penetrating injury (19% vs. 11%, p < 0.001), presented more often hypotensive to the emergency department (4% vs. 1%, p < 0.001), had more frequently a Glasgow Coma Scale (GCS) < or = 8 (9% vs. 3%, p < 0.001) and required more often an intubation at the injury scene (1.6% vs. 0.4%, p < 0.001). However, the transportation time and the total prehospital time were significantly shorter for airlifted patients. After multivariable analysis, the difference in mortality between the two transport modalities was not significant (adjusted odds ratio (95% confidence interval, 0.72 (0.22, 2.35); p = 0.596).
CONCLUSIONS: In a metropolitan Los Angeles trauma system, EMS helicopter transportation of injured patients does not appear to improve overall adjusted survival after injury. There is however a potential benefit for severely injured subgroups of patients due to the shorter prehospital times.
Authors:
Peep Talving; Pedro G R Teixeira; Galinos Barmparas; Joseph DuBose; Kenji Inaba; Lydia Lam; Demetrios Demetriades
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  33     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-12     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2469-76     Citation Subset:  IM    
Affiliation:
LAC+USC Medical Center, Division of Trauma Surgery and Surgical Critical Care, University of Southern California, 1200 North State Street, IPT, Room C4E100, Los Angeles, CA 90033, USA. peep.talving@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Air Ambulances*
Emergency Medical Services
Female
Humans
Injury Severity Score
Los Angeles
Male
Middle Aged
Registries
Survival Analysis
Transportation of Patients / methods*
Trauma Centers
Wounds and Injuries / mortality*,  therapy*
Young Adult
Comments/Corrections
Comment In:
World J Surg. 2010 Jul;34(7):1730; author reply 1731   [PMID:  20066414 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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