Comparative Effectiveness Studies Explore Cancer, Trauma Care
The issue is controversial, acknowledges Adil H. Haider, MD, one of the authors, because maintaining ready helicopter service for trauma centers is expensive, may have limited application due to geography, and because of questions about how quickly which types of trauma patients need to get to a hospital; perhaps life extending remedies some can be effectively treated in the field.
The report examined outcomes from treatment of 223,475 patients older than age 15 with injury severity scores higher than 15 taken to a level I or level II trauma center, as reflected by data from the American College of Surgeons National Trauma Data Bank.
While the raw numbers showed that mortality was higher for those injured patients transported by helicopter, helicopters carried more severely hurt patients. When adjusted for those variables, helicopter transport to level I trauma centers was associated with 16% better chance of survival compared with ground transport. For transport to level II trauma centers, there was a 15% better odds of survival.
"For patients transported to level I trauma centers by helicopter, 65 patients would need to be transported to save one life; for patients transported to level II trauma centers, the number needed to treat is 69," the researchers wrote.
The authors said that future research should hone in on what factors associated with helicopter medical rescue provide the additional benefit, such as improved pre-hospital intervention, total pre-hospital time, or crew configuration.
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