Citation

Guinzburg A, Gelikas S, Tsur AM, Nadler R, Sorkin A, Avital G, Radomislensky I, Bodas M, Segal D, Benov A, Chen J. Eur. J. Emerg. Med. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Lippincott Williams and Wilkins)

DOI

10.1097/MEJ.0000000000000940

PMID

35900102

Abstract

BACKGROUND: Helicopter emergency medical services (HEMS) allow for shorter transport duration in long-distance evacuations and facilitate advanced en-route medical care access. Studies comparing HEMS with ground emergency medical services (GEMS), including the outcome of prehospital mortality, are lacking.

OBJECTIVE: This study aimed to evaluate the association between HEMS and early mortality in Israel. SETTING: A retrospective cohort study was conducted of the cross-referenced Israel Defense Forces Trauma Registry and Israel National Trauma Registry databases. OUTCOME MEASURES AND ANALYSIS: Univariable logistic regression was used to assess the association between HEMS and early mortality, defined as mortality within 1 day of the injury. Regression analysis was further performed stratifying by event type (military or civilian) or type of injury (penetrating or nonpenetrating).

RESULTS: A total of 2344 casualties were included in the study, of whom 756 (32.3%) were evacuated by air. Early mortality rates were 90/1588 (5.7%) and 37/756 (4.9%) in GEMS and HEMS groups, respectively. Regression analysis found no significant analysis between HEMS and early mortality [OR, 0.86 (95% CI, 0.57-1.26)]. Stratified by event type, a nonsignificant association between HEMS and early mortality was demonstrated for combat [OR, 1.69 (95% CI, 0.79-3.92)] and noncombat [OR, 0.73 (95% CI, 0.4-1.25)] events. HEMS was associated with decreased early mortality among casualties with a penetrating injury [OR, 0.59 (95% CI, 0.34-0.98)] but not associated with early mortality among casualties with a nonpenetrating injury [OR, 0.84 (95% CI, 0.43-1.52)].

CONCLUSION: HEMS was not associated with a decrease in early mortality among trauma casualties in this study encompassing the prehospital and hospital scenes. There was a positive trend and a decrease in mortality from penetrating injuries. Further research to ascertain which casualties benefit from HEMS is warranted and will allow for more precise use of this expensive resource.

Language: en