Impact of a New Helicopter Base on Transport Time and Survival in a Rural Adult Trauma Population.

Autor: Sborov KD; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee., Gallagher KC; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee., Medvecz AJ; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee., Brywczynski J; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Gunter OL; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee., Guillamondegui OD; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee., Dennis BM; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee., Smith MC; Division of Trauma and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: michael.c.smith@vumc.org.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2020 Oct; Vol. 254, pp. 135-141. Date of Electronic Publication: 2020 May 21.
DOI: 10.1016/j.jss.2020.04.020
Abstrakt: Background: Significant disparities in access to prompt helicopter transport exist among rural trauma populations. We evaluated the impact of an additional helicopter base on transport time and mortality in a rural adult trauma population.
Materials and Methods: We performed a retrospective cohort study of adult patients with trauma transported by helicopter from scene to a level one trauma center between 2014 and 2018. A new rural helicopter base added to the trauma center's catchment area in 2016 served as the transition time for an interrupted time series analysis. Patients injured in this base's county and adjoining counties were analyzed. Baseline characteristics were compared with a Student's t-test and Pearson's chi-squared test. Cox and linear regression models evaluated the new base's effect on mortality and transport time, respectively.
Results: A total of 332 patients were analyzed: 120 (36.1%) transported before the addition of the new helicopter base and 212 (63.9%) transported after. Patients transported after the addition of the base had higher injury severity score (13.7 versus 10.1, P < 0.001) and were more likely to receive blood en route (19.3% versus 6.7%, P = 0.005). After the addition of the base, there was a decreased hazard ratio for mortality (hazard ratio 0.26, 95% confidence interval: 0.11-0.65, P = 0.004) with no significant change in transport time (-36.7 min, P = 0.071) for the area.
Conclusions: Local helicopter transport units may confer improved survival for the injured patient. This study demonstrates the important role of helicopter transport within a regional trauma system and the impact that expanded access to rapid air transport can have on mortality.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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