Citation

Bekelis K, Missios S, Mackenzie TA. Ann. Surg. 2014; 261(3): 579-585.

Affiliation

*Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH †Department of Neurosurgery, Cleveland Clinic, Cleveland, OH ‡Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH §Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH ‖The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/SLA.0000000000000672

PMID

24743624

Abstract

OBJECTIVE:: To investigate the association of helicopter transport with survival of patients with traumatic brain injury (TBI), in comparison with ground emergency medical services (EMS).

BACKGROUND:: Helicopter utilization and its effect on the outcomes of TBI remain controversial.

METHODS:: We performed a retrospective cohort study involving TBI patients who were registered in the National Trauma Data Bank between 2009 and 2011. Regression techniques with propensity score matching were used to investigate the association of helicopter transport with survival of TBI patients, in comparison with ground EMS.

RESULTS:: During the study period, there were 209,529 TBI patients who were registered in the National Trauma Data Bank and met the inclusion criteria. Of these patients, 35,334 were transported via helicopters and 174,195 via ground EMS. For patients transported to level I trauma centers, 2797 deaths (12%) were recorded after helicopter transport and 8161 (7.8%) after ground EMS. Multivariable logistic regression analysis demonstrated an association of helicopter transport with increased survival [OR (odds ratio), 1.95; 95% confidence interval (CI), 1.81-2.10; absolute risk reduction (ARR), 6.37%]. This persisted after propensity score matching (OR, 1.88; 95% CI, 1.74-2.03; ARR, 5.93%). For patients transported to level II trauma centers, 1282 deaths (10.6%) were recorded after helicopter transport and 5097 (7.3%) after ground EMS. Multivariable logistic regression analysis demonstrated an association of helicopter transport with increased survival (OR, 1.81; 95% CI, 1.64-2.00; ARR 5.17%). This again persisted after propensity score matching (OR, 1.73; 95% CI, 1.55-1.94; ARR, 4.69).

CONCLUSIONS:: Helicopter transport of TBI patients to level I and II trauma centers was associated with improved survival, in comparison with ground EMS.

Language: en