Seriously injured trauma patients transported to hospitals by helicopter are 16% more likely to survive than similarly injured patients brought in by ground ambulance, according to a new study from Johns Hopkins.
“We know helicopter trips are costly and carry some risks, but this research shows they do save lives,” says Adil Haider, MD, MPH, senior study author and an associate professor of surgery, anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “It also tells us that we need to sharpen our ability to identify trauma patients who need the helicopter most to ensure that we deploy the helicopter for people who really will benefit from its use.”
Medical evacuation helicopters come at a price, both in terms of financial costs and the rare but real risk of crash consequences associated with air flight, according to the study published the Journal of the American Medical Association. A medical helicopter trip costs thousands of dollars, the researchers say, which is charged, in most states, to insurance companies and consumers.
The research team analyzed records from more than 223,000 patients 16 years of age and older from the 2007-2009 National Trauma Data Bank. All patients sustained at least moderately severe injuries and were taken to trauma centers. The researchers compared the more than 161,500 patients who were transported by ambulance to the nearly 62,000 who were transported by helicopter.
When they adjusted for such factors as injury severity, type of injury and age of the patient, they determined that patients transported to the hospital by air were 16% more likely to survive than similarly injured patients transported by ground.
Among their conclusions was that one in 65 significantly injured patients brought to a Level I trauma center by helicopter would die if ground transportation was the only option.
Because no one can yet predict with precision in advance which patients might survive with a flight, transporting all with serious injury might seem warranted, Haider noted. But, he pointed out that in the case of those 65 patients, and using the average cost of helicopter transport in Maryland of $5,000 per patient, where costs are much lower than the average because it has the only state-run helicopter system in the United States, approximately $325,000 would have needed to be spent to transport all of them in order to save one life.
The advantage of a helicopter flight over an ambulance ride can be both the speed at which the patient gets to the hospital as well as the quality of the emergency medical team aboard the helicopter, which tend to carry the most experienced crews, Haider says.
“In some cases, helicopters don’t help, but just increase the risk because of the flight and add costs,” says Haider, co-director of the Johns Hopkins Center for Surgery Trials and Outcomes Research. “We need a better way to make sure this scarce and valuable resource is used appropriately.”
Source: Johns Hopkins Medicine