The coast and benefits of helicopter emergency medical services instead of the ground unit in traumatic patients: A cost-effectiveness analysis — Oak Academic Publishing
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The coast and benefits of helicopter emergency medical services instead of the ground unit in traumatic patients: A cost-effectiveness analysis
Department of Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran;
,
Department of Forensic Medicine and Traumatic Pathology, Alborz University of Medical Science, Karaj, Iran
,
Department of Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran;
,
Department of Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran;
,
Research Committee of Medical Science, Jondishapour University of Medical Science, Ahvaz, Iran
,
Department of Emergency Medicine, Gilan University of Medical Sceince, Rasht, Iran
,
Department of Radiation Medical Engineering, Isfahan University, Isfahan, Iran
1 Department of Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran;
2 Department of Forensic Medicine and Traumatic Pathology, Alborz University of Medical Science, Karaj, Iran
3 Department of Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran;
4 Department of Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran;
5 Research Committee of Medical Science, Jondishapour University of Medical Science, Ahvaz, Iran
6 Department of Emergency Medicine, Gilan University of Medical Sceince, Rasht, Iran
7 Department of Radiation Medical Engineering, Isfahan University, Isfahan, Iran
Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care; however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control the effect of other potentially influential variables. Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury. Methods: This was a cross-sectional study using our county trauma registry. All patients with trauma injury, who referred to our emergency department by helicopter or car, were included. The impact of aeromedical response was determined using logistic regression, adjusting for age, sex, mechanism, preadmissionGlasgowComa Scale score and Injury Severity Score. Finally, the aeromedical patients undergoing field intubation were compared with ground patients undergoing emergency department (ED) intubation. Results: A total of 243 patients meeting all inclusion and exclusion criteria and with complete data sets were identified. Overall mortality was 25% in the air- and ground-transported cohorts, but outcomes were not significantly better for the aeromedical patients when adjusted for age, sex, mechanism of injury, hypotension, Glasgow Coma Scale score, head Abbreviated Injury Score, and Injury Severity Score (adjusted odds ratio [OR] 1.90; 95% confidence interval [CI] 1.60 to 2.25; P: 0001). Good outcomes (discharge to home, jail, psychiatric facility, rehabilitation, or leaving against medical advice) were also higher in aeromedical patients (adjusted OR 1.36; 95% CI 1.18 to 1.58; P: 0001). Conclusion: Here we analyze a large database of patients with moderate to se vere traumatic brain injury. Aeromedical re sponse appears to yield no significantly improved outcomes after adjustment for multiple influential factors in patients with moderate to severe traumatic brain injury.
KeywordsEmergencyTraumatic PatientsAero Medical
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