Association of helicopter transportation and improved mortality for patients with major trauma in the northern French Alps trauma system: an observational study based on the TRENAU registry.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_83921D89E7BA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association of helicopter transportation and improved mortality for patients with major trauma in the northern French Alps trauma system: an observational study based on the TRENAU registry.
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
Author(s)
Ageron F.X., Debaty G., Savary D., Champly F., Albasini F., Usseglio P., Vallot C., Galvagno S., Bouzat P.
Working group(s)
TRENAU Group
Contributor(s)
Ageron F.X., Bouzat P., Albasini F., Champly F., Chapiteau L., Haller E., Hoareau C., Levrat A., Rancurel E., Savary D., Thouret J.M., Usseglio P., Muller S., Vallenet C., Vallot C., Venchiarutti D.
ISSN
1757-7241 (Electronic)
ISSN-L
1757-7241
Publication state
Published
Issued date
12/05/2020
Peer-reviewed
Oui
Volume
28
Number
1
Pages
35
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Prompt prehospital triage and transportation are essential in an organised trauma system. The benefits of helicopter transportation on mortality in a physician-staffed pre-hospital trauma system remains unknown. The aim of the study was to assess the impact of helicopter transportation on mortality and prehospital triage.
Data collection was based on trauma registry for all consecutive major trauma patients transported by helicopter or ground ambulance in the Northern French Alps Trauma system between 2009 and 2017. The primary endpoint was in-hospital death. We performed multivariate logistic regression to compare death between helicopter and ground ambulance.
Overall, 9458 major trauma patients were included. 37% (n = 3524) were transported by helicopter, and 56% (n = 5253) by ground ambulance. Prehospital time from the first call to the arrival at hospital was longer in the helicopter group compared to the ground ambulance group, respectively median time 95 [72-124] minutes and 85 [63-113] minutes (P < 0.001). Median transport time was similar between groups, 20 min [13-30] for helicopter and 21 min [14-32] for ground ambulance. Using multivariate logistic regression, helicopter was associated with reduced mortality compared to ground ambulance (adjusted OR 0.70; 95% CI, 0.53-0.92; P = 0.01) and with reduced undertriage (OR 0.69 95% CI, 0.60-0.80; P < 0.001).
Helicopter was associated with reduced in-hospital death and undertriage by one third. It did not decrease prehospital and transport times in a system with the same crew using both helicopter or ground ambulance. The mortality and undertriage benefits observed suggest that the helicopter is the proper mode for long-distant transport to a regional trauma centre.
Keywords
Emergency medical services, Helicopter, Mortality, Trauma, Triage
Pubmed
Web of science
Open Access
Yes
Create date
15/06/2020 14:22
Last modification date
15/01/2021 7:10
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