Outcomes of Blunt Trauma Victims Transported by HEMS from Rural andUrban Scenes

Abstract

Objective. Mortality differences exist between victims of urban andrural trauma; however, it is unknown if these differences persist in those patients who survive to HEMS transport. This study examined the in-hospital mortality, length of hospital stay, anddischarge status of adult blunt trauma victims transported by HEMS from rural andurban scenes to regional trauma centers. Methods. Retrospective review of all adult (age ≥ 15) HEMS transports in 2001; 271 urban and141 rural blunt trauma patients were identified from HEMS transport records andthe trauma registries at three level one trauma centers. Demographic data, scene andhospital interventions, as well as discharge status of the two groups were examined. Results. Total mileage [27 ± 12 vs. 119 ± 64, p < 0.001], total flight times (minutes) [30 ± 10 vs. 79 ± 40, p < 0.001], andscene times (minutes) [16 ± 8 vs. 21 ± 14, p < 0.001] were significantly longer for rural flights. There were no significant differences between the groups with regard to age, gender, receiving hospital, andinitial HEMS vitals. Injury Severity Score, ICU length of stay (LOS), total hospital LOS, andhospital mortality did not differ between the two groups. After controlling for age, gender, andISS, there were no significant mortality differences between the two groups (p = 0.074). Conclusions. Despite longer flight andscene times for rural patients, adjusted in-hospital mortality rates were similar for patients transported from urban andrural scenes. Factors prior to HEMS arrival may contribute to increased mortality rates of rural blunt trauma victims documented nationally.

Key words:

• out-of-hospital transport
• air medical transport
• blunt trauma
• outcomes