Retrospective review of injury severity, interventions and outcomes among helicopter and nonhelicopter transport patients at a Level 1 urban trauma centre

Hannay, R. Scott; Wyrzykowski, Amy D.; Ball, Chad G.; Laupland, Kevin B.; Feliciano, David V.

doi:10.1503/cjs.000113

Cited by 25 publications

(8 citation statements)

References 28 publications

(27 reference statements)

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“…The same can be seen in the study by Hannay et al. 21 They analysed 14,440 patient transports (17% of which were airborne). The ISS was significantly lower in comparison to our cohort (15.1 vs .…”

Section: Discussionsupporting

confidence: 76%

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Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU®

Bieler

Paffrath

Schmidt

et al. 2020

Chinese Journal of Traumatology

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Purpose The mortality rate for severely injured patients with the injury severity score (ISS) ≥16 has decreased in Germany. There is robust evidence that mortality is influenced not only by the acute trauma itself but also by physical health, age and sex. The aim of this study was to identify other possible influences on the mortality of severely injured patients. Methods In a matched-pair analysis of data from Trauma Register DGU®, non-surviving patients from Germany between 2009 and 2014 with an ISS≥16 were compared with surviving matching partners. Matching was performed on the basis of age, sex, physical health, injury pattern, trauma mechanism, conscious state at the scene of the accident based on the Glasgow coma scale, and the presence of shock on arrival at the emergency room. Results We matched two homogeneous groups, each of which consisted of 657 patients (535 male, average age 37 years). There was no significant difference in the vital parameters at the scene of the accident, the length of the pre-hospital phase, the type of transport (ground or air), pre-hospital fluid management and amounts, ISS, initial care level, the length of the emergency room stay, the care received at night or from on-call personnel during the weekend, the use of abdominal sonographic imaging, the type of X-ray imaging used, and the percentage of patients who developed sepsis. We found a significant difference in the new injury severity score, the frequency of multi-organ failure, hemoglobine at admission, base excess and international normalized ratio in the emergency room, the type of accident (fall or road traffic accident), the pre-hospital intubation rate, reanimation, in-hospital fluid management, the frequency of transfusion, tomography (whole-body computed tomography), and the necessity of emergency intervention. Conclusion Previously postulated factors such as the level of care and the length of the emergency room stay did not appear to have a significant influence in this study. Further studies should be conducted to analyse the identified factors with a view to optimising the treatment of severely injured patients. Our study shows that there are significant factors that can predict or influence the mortality of severely injured patients.

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Section: Discussionsupporting

confidence: 76%

“…Helicopter transport was associated with significantly higher pre-hospital rescue times. 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU®

Bieler

Paffrath

Schmidt

et al. 2020

Chinese Journal of Traumatology

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“…Furthermore, Hannay et al . reported that patients who were transported to an urban trauma center by helicopter were more severely injured and required more interventions, but had improved survival in comparison to those who arrived by other means of transport 7. Accordingly, in the present case, the use of DH might have led to a favorable outcome.…”

Section: Discussionmentioning

confidence: 62%

A system of delivering medical staff members by helicopter to manage severely wounded patients in an area where medical resources are limited

Ishikawa

Omori

Ohsaka

et al. 2016

Acute Medicine & Surgery

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AimWe review the case of a severely injured patient to evaluate the system of delivering medical staff by helicopter in areas with limited medical resources.MethodsThe patient's chart was reviewed, summarized, and presented.ResultsA 22‐year‐old woman attempted a suicidal fall after using a knife to stab herself. She was transported to a local hospital. A radiological study revealed fractures to the patient's face and the base of her skull, pneumocephalus, traumatic subarachnoid hemorrhage, stab wounds to the neck and chest, pneumothorax, unstable pelvic fracture, and right femoral shaft fracture. Her circulation status became unstable. We sent medical staff members to the local hospital by doctor helicopter. The patient underwent tracheal intubation and the insertion of a chest drain, and was evacuated by doctor helicopter. After aggressive intensive treatments in our hospital, the patient finally obtained social rehabilitation.ConclusionIn an area where medical resources are limited, sending trained physicians to a referring hospital to appropriately prepare a severely wounded patient for transportation might be the key for the patient to maximize his or her chance of survival.

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“…The utility of helicopter transport for trauma patients has been debated widely in the literature, with varying conclusions. 7,11,12,14,15,21–24 Unlike these previous studies, we eliminated no-fly days and accounted for geographic variables in our analyses, and we found that helicopter transport was not associated with mortality during index hospitalization. We did find that 12% of our patients who were transported by air did not meet criteria for hospital admission of greater than 24 hours.…”

Section: Discussionmentioning

confidence: 94%

It's All About Location, Location, Location

Shaw

Psoinos²,

Santry³

2016

Annals of Surgery

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Retrospective review of injury severity, interventions and outcomes among helicopter and nonhelicopter transport patients at a Level 1 urban trauma centre

Cited by 25 publications

References 28 publications

Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU®

Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU®

A system of delivering medical staff members by helicopter to manage severely wounded patients in an area where medical resources are limited

It's All About Location, Location, Location

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