T Rauma H Elicopter E Mergency M Edical S Ervices T Ransport : A Nnotated R Eview of S Elected O Utcomes-Related L Iterature

Thomas, Stephen; Cheema, Farah; Wedel, Suzanne K.; Thomson, David P.

doi:10.1080/10903120290938508

Cited by 54 publications

(14 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the impact of HEMS and GEMS is still debated, our findings support the results of recent studies on HEMS with advanced statistics [1,2,7-10]. Actually, the ORs reported in those studies were very similar (Table 6).…”

Section: Discussionsupporting

confidence: 89%

Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan

et al. 2014

View full text Add to dashboard Cite

IntroductionHelicopter emergency medical services with a physician (HEMS) has been provided in Japan since 2001. However, HEMS and its possible effect on outcomes for severe trauma patients have still been debated as helicopter services require expensive and limited resources. Our aim was to analyze the association between the use of helicopters with a physician versus ground services and survival among adults with serious traumatic injuries.MethodsThis multicenter prospective observational study involved 24,293 patients. All patients were older than 15 years of age, had sustained blunt or penetrating trauma and had an Injury Severity Score (ISS) higher than 15. All of the patient data were recorded between 2004 and 2011 in the Japan Trauma Data Bank, which includes data from 114 major emergency hospitals in Japan. The primary outcome was survival to discharge from hospitals. The intervention was either transport by helicopter with a physician or ground emergency services.ResultsA total of 2,090 patients in the sample were transported by helicopter, and 22,203 were transported by ground. Overall, 546 patients (26.1%) transported by helicopter died compared to 5,765 patients (26.0%) transported by ground emergency services. Patients transported by helicopter had higher ISSs than those transported by ground. In multivariable logistic regression, helicopter transport had an odds ratio (OR) for survival to discharge of 1.277 (95% confidence interval (CI), 1.049 to 1.556) after adjusting for age, sex, mechanism of injury, type of trauma, initial vital signs (including systolic blood pressure, heart rate and respiratory rate), ISS and prehospital treatment (including intubation, airway protection maneuver and intravenous fluid). In the propensity score–matched cohort, helicopter transport was associated with improved odds of survival compared to ground transport (OR, 1.446; 95% CI, 1.220 to 1.714). In conditional logistic regression, after adjusting for prehospital treatment (including intubation, airway protection maneuver and intravenous fluid), similar positive associations were observed (OR, 1.230; 95% CI, 1.017 to 1.488).ConclusionsAmong patients with major trauma in Japan, transport by helicopter with a physician may be associated with improved survival to hospital discharge compared to ground emergency services after controlling for multiple known confounders.

show abstract

Section: Discussionsupporting

confidence: 89%

Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Results have been variable, but most studies have shown outcome benefit. 1,3,4 One issue ubiquitous in the TRISS literature is the inability to randomize patients to air vs. ground transport with all the inherent weaknesses in observational, nonrandomized studies, which demonstrate elements of association and potentially unmeasured confounders. Without randomization, it becomes impossible to control for the multiple confounding variables that culminate in a patient's being selected for air vs. ground transport.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence for the effectiveness of HEMS in both trauma and nontrauma settings has been the subject of much debate in the medical literature over the past two decades. [1][2][3][4] There has been increased scrutiny of air medical transport, which must justify itself in the light of growing safety and economic concerns. [5][6][7] While study methodologies evaluating HEMS in trauma have included observational studies, stratified analyses, and before-and-after studies, Trauma Injury Severity Score (TRISS)-based analyses have been the most commonly utilized study method.…”

Section: Introductionmentioning

confidence: 99%

Air Versus Ground Transport of the Major Trauma Patient: A Natural Experiment

McVey

Petrie

Tallon

2009

Prehospital Emergency Care

View full text Add to dashboard Cite

show abstract

“…In this setting, helicopter utilization and its effect on outcomes of TBI remain an issue of debate. 2–7 …”

mentioning

confidence: 99%

Prehospital Helicopter Transport and Survival of Patients With Traumatic Brain Injury

2015

View full text Add to dashboard Cite

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 patients with TBI 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 patients with TBI, in comparison with ground EMS. Results During the study period, there were 209,529 patients with TBI 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 patients with TBI to level I and II trauma centers was associated with improved survival, in comparison with ground EMS.

show abstract

T Rauma H Elicopter E Mergency M Edical S Ervices T Ransport : A Nnotated R Eview of S Elected O Utcomes-Related L Iterature

Cited by 54 publications

References 1 publication

Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan

Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan

Air Versus Ground Transport of the Major Trauma Patient: A Natural Experiment

Prehospital Helicopter Transport and Survival of Patients With Traumatic Brain Injury

Contact Info

Product

Resources

About