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786 In-hospital mortality based on the mode of EMS transportation in high-income developing middle Eastern Country
  1. Hassan Al-Thani1,
  2. Ayman El-Menyar1,
  3. Yugan Pillay2,
  4. Monira Mollazehi1,
  5. Ahammad Mekkodathil1,
  6. Rafael Consunji1
  1. 1Trauma Surgery
  2. 2EMS Services, Hamad General Hospital, Doha, Qatar

Abstract

Background Helicopter emergency medical services (HEMS) have become a standard element of advanced pre-hospital care system. Positive outcomes in HEMS transportation were evident in different settings and certain types of patients. The present study assessed presentations and outcomes in trauma patients transported by HEMS and ground emergency medical services (GEMS) in Qatar.

Methods A retrospective review of trauma registry data at Hamad Trauma Centre (HTC) was conducted for trauma patients transported by GEMS and HEMS in the duration from 2011 to 2013. Patients were classified into two groups based on the mode of transportation (HEMS vs GEMS). Injury severity score (ISS) was defined as severe/profound trauma (>15) and mild/moderate trauma (≤ 15). Mortality was defined as brought in dead (BID), within the first day, within the first week and more than 1 week.

Results A total of 4596 patients with traumatic injuries were included (7% HEMS). When compared with GEMS, the mean ISS, Head AIS and scene GCS were greater in HEMS (p = 0.001). Nearly 12% of ISS > 15 and 5% of ISS ≤ 15 were transported by HEMS. The main mechanism of injury was motor vehicle crash (MVC) (37%) followed by fall (25%) and pedestrians (14%). MVC victims were more likely to be transported by HEMS whereas fall and pedestrians victims were frequently transported by GEMS (p < 0.05). On-scene rate of intubation was higher in HEMS irrespective of ISS score (p = 0.001). Overall mortality, in-hospital deaths and BID was 10.2%, 7.5% and 3%; respectively. The mortality was 2.5-fold higher in victims transported by HEMS compared with GEMS (10% vs 4%, p = 0.001). Mortality within the first day and more than one week were higher with HEMS, however, it was greater within the first week in GEMS. Age and mode of transportation -adjusted predictors of mortality were ISS and scene GCS.

Conclusions MVCs are the main mechanism of injury in Qatar. Polytrauma and scene GCS play important prognostic role regardless the mode of transportation. These findings indicate the need of more effective preventive measure on the road

  • Helicopter
  • Ground emergency medical services
  • MVC
  • Trauma

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