Predictors of Inappropriate Helicopter Transport. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Brown, Christopher; Irfan, Wajeeh; Schoen, Jonathan E.; Marr, Alan B.; Stuke, Lance E.; Cavalea, Alexander C.; Mosier, Willard W.; Rogers, Camille L.; Greiffenstein, Patrick P.; Moore, Margaret M.; Hunt, John P.
• Is Part Of: American surgeon. Volume 87:Issue 2(2021)
• Page Start: 248
• Page End: 252
• Publication Date: 2021-02
• Subjects: trauma -- trauma acute care -- air transport -- helicopter; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/0003134820951423
• Languages: English
• ISSNs: 0003-1348

Abstract

Background: Helicopter transport (HT) is an efficient, but costly, means for injured patients to receive life-saving, definitive trauma care. Identifying the characteristics of inappropriate HT presents an opportunity to improve the utilization of this finite medical resource. Methods: Trauma registry records of all HT for a 3-year period (2016-2018) to an urban Level I trauma center were reviewed. HT was defined as inappropriate for patients who were discharged home from the emergency department or had a hospital length of stay <1 day, and who were discharged alive. Chi-square analysis and Student's t -test were used for univariate analysis. Predictors with a P value of less than .15 were subject to binary logistic regression analysis. A P value ≤.05 was considered significant. Results: There were 713 patients who received HT during the study period. One-hundred and forty-eight (20.8%) patients met the criteria as an inappropriate HT. In univariate analysis, Glasgow Coma Scale >8, Shock Index <0.9, and fall mechanism were found to be significantly associated with inappropriate HT. Age >55 was found to be associated with an appropriate HT. The average Injury Severity Score of the inappropriate HT group was 3.86 (±3.85) compared with 16.80 (±11.23) ( P = .0001, Student's t -test). Discussion: Our findings suggest that there are evidence-based predictors of patients receiving inappropriate HT. Triage of HT using these predictors has the potential to decrease unnecessary deployments and reduce health care costs.