Stop Flying the Patients! Evaluation of the Overutilization of Helicopter Transport of Trauma Patients

Introduction: Helicopter transport is a resource intensive and expensive method for transportation of patients by helicopter. The primary objective of this study was to evaluate the appropriateness of helicopter transport determined by procedural care within 1-h of transfer at an urban level I trauma center. Methods: All trauma patients transported by helicopter from January 2015-December 2017 to an urban level I trauma center from referring hospitals or the scene were retrospectively analyzed. A subgroup analysis was performed evaluating patients that required a procedure or operation within 1-h of transport compared with the remainder of the patient cohort who were transported via helicopter. Results: A total of 1590 patients were transported by helicopter. Thirty-nine percent of patients (n = 612) were admitted directly to the floor from the trauma bay and 16% (n = 249) of patients required only observation or were discharged home after helicopter transfer. Approximately one-third of the entire study cohort (36%, n = 572) required any procedure, with a median time to procedure of 31.5 h (interquartile range 54.4). Only 13% (n = 74) required a procedure within 1-h of helicopter transport. The average distance (in miles) if the patient had been driven by ground transport rather than helicopter was 67.0 miles (SD +/- 27.9) and would take an estimated 71.5 min (+/- 28.4) for patients who required a procedure within 1-h compared with 61.6 miles (SD +/- 30.9) with an estimated 66.1 min (SD +/- 30.8) for the remainder of the cohort (P value 0.899 and 0.680, respectively). Conclusions: This analysis demonstrates that helicopter transport was not necessary for the vast majority of trauma patients transported via helicopter. (C) 2020 Elsevier Inc. All rights reserved.