• Login
    View Item 
    •   UMB Digital Archive
    • UMB Open Access Articles
    • UMB Open Access Articles 2018
    • View Item
    •   UMB Digital Archive
    • UMB Open Access Articles
    • UMB Open Access Articles 2018
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Improved Survival for Rural Trauma Patients Transported by Helicopter to a Verified Trauma Center: A Propensity Score Analysis

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Author
    Zhu, T.H.
    Hollister, L.
    Opoku, D.
    Date
    2018
    Journal
    Academic Emergency Medicine
    Publisher
    Blackwell Publishing Inc.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.1111/acem.13307
    Abstract
    Objectives: Recent studies using advanced statistical methods to control for confounders have demonstrated an association between helicopter transport (HT) versus ground ambulance transport (GT) in terms of improved survival for adult trauma patients. The aim of this study was to apply a methodologically vigorous approach to determine if HT is associated with a survival benefit for when trauma patients are transported to a verified trauma center in a rural setting. Methods: The ascertainment of trauma patients age ≥ 15 years (n = 469 cases) by HT and (n = 580 cases) by GT between 1999 and 2012 was restricted to the scene of injury in a rural area of 10 to 35 miles from the trauma center. The propensity score (PS) was determined using data including demographics, prehospital physiology, intubation, total prehospital time, and injury severity. The PS matching was performed with different calipers to select a higher percentage of matches of HT compared to GT patients. The outcome of interest was survival to discharge from hospital. Identical logistic regression analysis was done taking into account for each matched design to select an appropriate effect estimate and confidence interval (CI) controlling for initial vital signs in the emergency department, the need for urgent surgery, intensive care unit admission, and mechanical ventilation. Results: Unadjusted mortalities for HT compared to GT were 7.7 and 5.3%, respectively (p > 0.05). The adjusted rates were 4.0% for HT and 7.6% for GT (p < 0.05). In a PS well‐matched data set, HT was associated with a 2.69‐fold increase in odds of survival compared to GT patients (adjusted odds ratio = 2.69; 95% CI = 1.21–5.97). Conclusions: In a rural setting, we demonstrated improved survival associated with HT compared to GT for scene transportation of adult trauma patients to a verified Level II trauma center using an advanced methodologic approach, which included adjustment for transport distance. The implication of survival benefit to rural population is discussed. We recommend larger studies with multiple trauma systems need to be repeated using similar study methodology to substantiate our findings. Copyright 2017 The Authors. Academic Emergency Medicine published by Wiley Periodicals, Inc. on behalf of Society for Academic Emergency Medicine.
    Keyword
    traumatic injuries
    Air Ambulances
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85032800900&doi=10.1111%2facem.13307&partnerID=40&md5=6fe380cb032156330b2c8793e40737dc; http://hdl.handle.net/10713/9100
    ae974a485f413a2113503eed53cd6c53
    10.1111/acem.13307
    Scopus Count
    Collections
    UMB Open Access Articles 2018

    entitlement

    Related articles

    • Association between helicopter vs ground emergency medical services and survival for adults with major trauma.
    • Authors: Galvagno SM Jr, Haut ER, Zafar SN, Millin MG, Efron DT, Koenig GJ Jr, Baker SP, Bowman SM, Pronovost PJ, Haider AH
    • Issue date: 2012 Apr 18
    • Association of direct helicopter versus ground transport and in-hospital mortality in trauma patients: a propensity score analysis.
    • Authors: Stewart KE, Cowan LD, Thompson DM, Sacra JC, Albrecht R
    • Issue date: 2011 Nov
    • Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport.
    • Authors: Chen X, Gestring ML, Rosengart MR, Billiar TR, Peitzman AB, Sperry JL, Brown JB
    • Issue date: 2018 Apr
    • Is helicopter evacuation effective in rural trauma transport?
    • Authors: Rose MK, Cummings GR, Rodning CB, Brevard SB, Gonzalez RP
    • Issue date: 2012 Jul
    • [Pediatric prehospital trauma care. A retrospective comparison of air and ground transportation].
    • Authors: Schmidt U, Geerling J, Fühler M, Hubrich V, Richter M, Krettek C
    • Issue date: 2002 Nov
    DSpace software (copyright © 2002 - 2021)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.