S. M. Farach1, L. Bendure1, P. D. Danielson1, E. Amankwah2, N. M. Chandler1, N. E. Walford1 1All Children’s Hospital Johns Hopkins Medicine,Pediatric Surgery,Saint Petersburg, FLORIDA, USA 2All Children’s Hospital Johns Hopkins Medicine,Clinical And Translational Research Organization,Saint Petersburg, FLORIDA, USA
Introduction: Studies have shown that survival after trauma is improved by the timely transfer of injured patients to a trauma center. There is conflicting data to support the routine use of helicopter transport for trauma patients. The purpose of this study is to evaluate outcomes for trauma patients transported via helicopter to a regional pediatric trauma center.
Methods: The institutional trauma registry was queried for all trauma patients presenting from January 2000 through March 2012. Of 9119 patients, 1709 patients who presented from the scene were selected for further evaluation. This cohort was stratified into helicopter transport (HT) versus ground transport (GT) for analysis. Significance was defined at p ≤ 0.05.
Results: Table 1 describes select demographic and outcomes data between the groups. There were no differences between the groups with regards to age or gender. Patients arriving by HT had a higher injury severity score (ISS), lower Glasgow Coma Scale (GCS), were less likely to undergo surgery within 24 hours, were more likely to present after motorized trauma, and had longer intensive care unit (ICU) and hospital length of stay. When controlled for ISS, patients arriving by HT had a higher rate of pre-hospital intubation, had significantly higher ICU admissions, and longer hospital length of stay. There was no difference in 30 day mortality compared to patients arriving by GT. Patients presenting from less than 20 miles were more likely to arrive by GT while those presenting from distances greater than 20 miles were more likely to arrive by HT. When controlled for ISS, there was no significant difference noted from time of injury to hospital arrival between the two transport groups at distances less than 40 miles.
Conclusion: In distances less than 40 miles, transport to the trauma center was not improved by HT. While patients arriving by helicopter are more severely injured and arrive from greater distances, when controlling for ISS, there is no difference in mortality when compared to patients arriving by ground transport.
