Helicopter transport is associated with a small but real benefit, but it comes at a high cost.

To compare outcomes between air and ground transport for adult trauma patients with Injury Severity Scores >15, researchers reviewed the American College of Surgeons National Trauma Data Bank from 2007 to 2009. Only patients who arrived at level I and level II trauma centers alive and had complete data on transport and disposition were included in the analysis. The final study population comprised 62,000 patients transported by air and 162,000 patients transported by ground. Neither the care rendered during transport nor the type of clinician who rendered it was considered.


Unadjusted mortality was significantly higher in the helicopter-transport group (12.6% vs. 11.0%). However, the helicopter-transport group had significantly higher Injury Severity Scores and heart rate, with lower respiratory rate, systolic blood pressure, and Glasgow Coma Scale motor scores. In propensity score-matched logistic regression analysis, helicopter transport yielded a 1.5% absolute survival advantage. Sixty-five patients would need to be transported to level I centers by helicopter to save one life, and 69 patients at level II centers. Each life saved would cost approximately US$325,000.


Citation(s):

Galvagno SM Jr et al. Association between helicopter vs ground emergency medical services and survival for adults with major trauma. JAMA 2012 Apr 18; 307:1602.