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Original Articles
The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study
Myung Jin Jang, Woo Sung Choi, Jung Nam Lee, Won Bin Park
Received October 9, 2023  Accepted November 30, 2023  Published online February 23, 2024  
DOI: https://doi.org/10.20408/jti.2023.0074    [Epub ahead of print]
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  • 4 Download
AbstractAbstract PDF
Purpose
Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation.
Methods
This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared.
Results
The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences.
Conclusions
DHTAE was associated with significantly longer transport times to the trauma center, as well as non-statistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.
Summary
Comparative Evaluation of Emergency Medical Service Trauma Patient Transportation Patterns Before and After Level 1 Regional Trauma Center Establishment: A Retrospective Single-Center Study
Hyeong Seok Lee, Won Young Sung, Jang Young Lee, Won Suk Lee, Sang Won Seo
J Trauma Inj. 2021;34(2):87-97.   Published online March 24, 2021
DOI: https://doi.org/10.20408/jti.2020.0021
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  • 128 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

This study examined emergency medical service (EMS) transportation patterns for adult trauma patients before and after establishing a level 1 regional trauma center (RTC) and to evaluate the transportation approach after prehospital severity screening.

Methods

This was a retrospective observational study of trauma patients aged ≥18 years admitted via EMS to the emergency department or a level 1 RTC, 1 year before to 3 years after RTC establishment. Patients with an Injury Severity Score (ISS) in the patient registration system were selected. Analyses were performed to determine transportation pattern changes by comparing patients pre- and post-RTC establishment and by yearly comparisons over the 4-year study period using the Mann-Whitney U test and chi-square test.

Results

Overall, 3,587 patients were included. The mean ISS was higher in the post-RTC group (n=2,693; 10.63±8.90, median 9.00) than in the pre-RTC group (n=894; 9.44±8.20, median 8.00; p<0.001). The mean transportation distance (9.84±13.71, median 5.80 vs. 13.12±16.15 km, median 6.00; p<0.001) was longer in the post-RTC group than in the pre-RTC group. Furthermore, proportionally fewer patients were transported from an area in the same city as the RTC after establishment (86.1% vs. 78.3%; p<0.001). Yearly comparisons revealed a gradually increasing trend in the hospital death rate (ptrend=0.031).

Conclusions

After establishing a level 1 RTC, the EMS transportation of severe trauma patients increased gradually along with the long-distance transportation of minor trauma patients. Therefore, improved prehospital EMS trauma severity assessments and level 1 RTC involvement in patient classification in the prehospital phase are necessary.

Summary

Citations

Citations to this article as recorded by  
  • Establishment of Emergency Teaching Model and Optimization of Discrete Dynamic Calculation in Complex Virtual Simulation Environment
    He Li, Yuansong Sun, Kai Song, Chunlin Yin, Gengxin Sun
    Mathematical Problems in Engineering.2022; 2022: 1.     CrossRef
  • Model for Predicting In-Hospital Mortality of Physical Trauma Patients Using Artificial Intelligence Techniques: Nationwide Population-Based Study in Korea
    Seungseok Lee, Wu Seong Kang, Sanghyun Seo, Do Wan Kim, Hoon Ko, Joongsuck Kim, Seonghwa Lee, Jinseok Lee
    Journal of Medical Internet Research.2022; 24(12): e43757.     CrossRef
Analysis of Cultivator-related Trauma Cases in a Regional Trauma Center in the Rural Area of Gyeongbuk Province
Ui Kang Hwang, Seok Hwa Youn, Chan Yong Park
J Trauma Inj. 2017;30(3):80-86.   Published online October 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.3.80
  • 1,969 View
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AbstractAbstract PDF
PURPOSE
To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province.
METHODS
We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015.
RESULTS
The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia.
CONCLUSIONS
As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.
Summary
Association between Helicopter Versus Ground Emergency Medical Services in Inter-Hospital Transport of Trauma Patients
Kyeong Guk Kang, Jin Seong Cho, Jin Ju Kim, Yong Su Lim, Won Bin Park, Hyuk Jun Yang, Geun Lee
J Trauma Inj. 2015;28(3):108-114.   Published online September 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.3.108
  • 1,987 View
  • 11 Download
  • 1 Citations
AbstractAbstract PDF
PURPOSE
To improve outcome of severe trauma patient, the shortening of transport time is needed. Although helicopter emergency medical services (HEMS) is still a subject of debate, it must also be considered for trauma system. The aim of this study is to assess whether transport method (HEMS versus ground EMS) is associated with outcome among inter-hospital transport.
METHODS
All trauma patients transported to regional emergency center by either HEMS or ground EMS from September 2011 to September 2014. We have classified patients according to two groups by transport method. Age younger than 15 years and self-discharged patients were excluded.
RESULTS
A total of 427 patients were available for analysis during this period. 60 patients were transported by HEMS and 367 patients were transported by ground EMS. HEMS group had higher mortality than ground EMS group (23.3% vs 3.5%; p<0.001), and included more patients with excess mortality ratio adjusted injury severity score (EMR-ISS)above 25 (91.7% vs 48.8%; p<0.001). In the multivariable regression analysis, HEMS was not associated with improved outcome compared with ground EMS, but only EMR-ISS was associated with a mortality of patients (odds ratio, 1.06; 95% confidence interval, 1.04-1.09).
CONCLUSION
In this study, helicopter emergency medical services transport was not associated with a decreased of mortality among the trauma patients who inter-hospital transported to the regional emergency center.
Summary

Citations

Citations to this article as recorded by  
  • Reduced Mortality in Severely Injured Patients Using Hospital-based Helicopter Emergency Medical Services in Interhospital Transport
    Oh Hyun Kim, Young-Il Roh, Hyung-Il Kim, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Sung Oh Hwang, Kang Hyun Lee
    Journal of Korean Medical Science.2017; 32(7): 1187.     CrossRef

J Trauma Inj : Journal of Trauma and Injury