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Helicopter Scene Transport of Trauma Patients with Nonlife-Threatening Injuries: A Meta-Analysis

Bledsoe, Bryan E. DO, FACEP; Wesley, A Keith MD, FACEP; Eckstein, Marc MD, FACEP; Dunn, Thomas M. PhD; O’Keefe, Michael F. MS

The Journal of Trauma: Injury, Infection, and Critical Care: June 2006 - Volume 60 - Issue 6 - p 1257-1266
doi: 10.1097/01.ta.0000196489.19928.c0
Original Articles

Background: Helicopters have become a major part of the modern trauma care system and are frequently used to transport patients from the scene of their injury to a trauma center. While early studies reported decreased mortality for trauma patients transported by helicopters when compared with those transported by ground ambulances, more recent research has questioned the benefit of helicopter transport of trauma patients. The purpose of this study was to determine the percentage of patients transported by helicopter who have nonlife-threatening injuries.

Methods: A meta-analysis was performed on peer-review research on helicopter utilization. The inclusion criteria were all studies that evaluated trauma patients transported by helicopter from the scene of their injury to a trauma center with baseline parameters defined by Injury Severity Score (ISS), Trauma Score (TS), Revised Trauma Score (RTS), and the likelihood of survival as determined via Trauma Score-Injury Severity Score (TRISS) methodology.

Results: There were 22 studies comprising 37,350 patients that met the inclusion criteria. According to the ISS, 60.0% [99% confidence interval (CI): 54.5–64.8] of patients had minor injuries, According to the TS, 61.4% (99% CI: 60.8–62.0) of patients had minor injuries. According to TRISS methodology, 69.3% (99% CI: 58.5–80.2) of patients had a greater than 90% chance of survival and thus nonlife-threatening injuries. There were 25.8% (99% CI: −1.0–52.6) of patients discharged within 24 hours after arrival at the trauma center.

Conclusions: The majority of trauma patients transported from the scene by helicopter have nonlife-threatening injuries. Efforts to more accurately identify those patients who would benefit most from helicopter transport from the accident scene to the trauma center are needed to reduce helicopter overutilization.

From the The George Washington University Medical Center (B.B.), Washington, DC; Saint Johns Hospital (K.W.), Minneapolis, MN; University of Southern California (M.E.), Los Angeles, CA; University of Northern Colorado (T.D.), Greeley, CO; and Vermont Department of Health (M.O.), Burlington, VT.

Submittted for publication October 12, 2004.

Accepted for publication May 18, 2005.

Address for Reprints: Bryan Bledsoe, DO, 6420 Hayes Road, Midlothian, Texas 76065-5235; email:

© 2006 Lippincott Williams & Wilkins, Inc.