Citation

Missios S, Bekelis K. J. Neurotrauma 2014; 31(14): 1321-1328.

Affiliation

Cleveland Clinic, Neurosurgery, Cleveland, Ohio, United States ; smissios@gmail.com.

Copyright

(Copyright © 2014, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3325

PMID

24605922

Abstract

The use of helicopter emergency medical services (EMS) for pediatric trauma patients is an issue of debate. We investigated the association of helicopter transport with survival of pediatric traumatic brain injury (TBI) patients. We conducted a retrospective cohort study of pediatric TBI patients who were transported to level I and II trauma centers and were registered in the National Trauma Data Bank (NTDB) between 2009 and 2011. We used regression techniques, integrating the results of propensity score matching, to investigate the association of helicopter transport with survival, in comparison to ground EMS. There were 15,704 pediatric TBI patients who met the inclusion criteria. Of these, 3,142 were transported via helicopters, and 12,562 via ground EMS. The mortality for children transported to level I trauma centers was 7.5% (183 deaths) for helicopter transport, and 3.8% (337 deaths) for ground. Multivariable logistic regression analysis demonstrated an association of helicopter transport with increased survival [OR, 1.76; 95% CI, 1.27-2.46; Absolute Risk Reduction, 2.70%]. This persisted after propensity score matching (OR, 1.77; 95% CI, 1.25-2.52;ARR 2.73 %). The mortality for children transported to level II trauma centers was 8.0% (52 deaths) for helicopter transport, and 4.4% (163 deaths) for ground. Multivariable logistic regression analysis demonstrated an association of helicopter transport with increased survival (OR, 2.35; 95% CI, 1.30-4.25; ARR 5.36%). This again persisted after propensity score matching (OR 2.56; 95% CI 1.28-5.11;ARR 6.14). Pediatric patients with TBI transported to level I and II trauma centers had improved survival in comparison to similar patients transported via ground EMS.

Language: en