Trauma patients more likely to survive if rescued by helicopter

Emergency medical helicopters are certainly dramatic (especially on TV shows like “ER” and “Grey’s Anatomy”), but are they really so much better than ambulances that they’re worth the extra cost? A new study says the answer is yes.

Researchers from the University of Maryland School of Medicine culled data from the National Trauma Data Bank on 61,909 patients who were transported to a hospital via helicopter between 2007 and 2009 and compared them with 161,566 patients who were taken to the hospital in an ambulance. Overall, the patients transported by air were more seriously injured than patients transported by ground, and they had higher heart rates, lower respiratory rates and worse blood pressure, among other problems. Not surprisingly then, a greater proportion of helicopter patients died from their injuries (12.6%) compared to ambulance patients (11%).

But after the researchers used statistical techniques to control for these differences, they found that helicopter transport was linked with a better chance of survival.

Among patients brought to a level 1 trauma center (such as LAC+USC Medical Center or Ronald Reagan UCLA Medical Center), those who arrived by helicopter were 16% more likely to be discharged from the hospital than patients who arrived by ambulance. For patients who went to level 2 trauma centers (such as Huntington Memorial Hospital in Pasadena), helicopter patients were 15% more likely to be discharged compared to ambulance patients. The results will be published in Wednesday’s edition of the Journal of theAmerican Medical Assn.

How should we think about those numbers? As the study authors wrote, emergency medical services teams would have to transport 65 patients by helicopter to a level 1 trauma center in order to save one life. (For a level 2 trauma center, it would take 69 patients to save one life.)

It’s not clear exactly how helicopter rides translate into better outcomes for patients. Certainly one possibility is that patients get to the hospital faster when they travel by air. But patients may also benefit from getting more procedures in a helicopter or being treated by a crew that includes more physicians and nurses instead of emergency medical technicians, the researchers wrote.

The cost of helicopter transport varies widely, with some hospitals reporting annual expenses as low as $114,777 and others going as high as $4.5 million, according to the JAMA study. In the researchers’ home state of Maryland, the average cost of airlifting a patient to the hospital is $5,000. Based on that figure, they wrote, it would cost $325,000 to save one life. Given the urgency to control medical costs in the U.S., “policy makers should consider funding a formal cost-effectiveness analysis” to determine whether this is a wise use of resources, they added.

You can read a summary of the study here.

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