Background 

Helicopter emergency medical services (HEMS) allow for shorter transport duration in long-distance evacuations and facilitate advanced en-route medical care access. Studies comparing HEMS with ground emergency medical services (GEMS), including the outcome of prehospital mortality, are lacking.

Objective 

This study aimed to evaluate the association between HEMS and early mortality in Israel.

Setting 

A retrospective cohort study was conducted of the cross-referenced Israel Defense Forces Trauma Registry and Israel National Trauma Registry databases.

Outcome measures and analysis 

Univariable logistic regression was used to assess the association between HEMS and early mortality, defined as mortality within 1 day of the injury. Regression analysis was further performed stratifying by event type (military or civilian) or type of injury (penetrating or nonpenetrating).

Results 

A total of 2344 casualties were included in the study, of whom 756 (32.3%) were evacuated by air. Early mortality rates were 90/1588 (5.7%) and 37/756 (4.9%) in GEMS and HEMS groups, respectively. Regression analysis found no significant analysis between HEMS and early mortality [OR, 0.86 (95% CI, 0.57–1.26)]. Stratified by event type, a nonsignificant association between HEMS and early mortality was demonstrated for combat [OR, 1.69 (95% CI, 0.79–3.92)] and noncombat [OR, 0.73 (95% CI, 0.4–1.25)] events. HEMS was associated with decreased early mortality among casualties with a penetrating injury [OR, 0.59 (95% CI, 0.34–0.98)] but not associated with early mortality among casualties with a nonpenetrating injury [OR, 0.84 (95% CI, 0.43–1.52)].

Conclusion 

HEMS was not associated with a decrease in early mortality among trauma casualties in this study encompassing the prehospital and hospital scenes. There was a positive trend and a decrease in mortality from penetrating injuries. Further research to ascertain which casualties benefit from HEMS is warranted and will allow for more precise use of this expensive resource.

中文翻译：

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直升机紧急医疗服务与早期伤员生存之间的关系：一项全国性研究

背景 

直升机紧急医疗服务 (HEMS) 可以缩短长途疏散的运输时间，并促进先进的途中医疗护理服务。目前还缺乏将 HEMS 与地面紧急医疗服务 (GEMS) 进行比较的研究，包括院前死亡率的结果。

客观的 

本研究旨在评估以色列 HEMS 与早期死亡率之间的关联。

环境 

对以色列国防军创伤登记数据库和以色列国家创伤登记数据库进行了一项回顾性队列研究。

结果衡量和分析 

使用单变量逻辑回归评估 HEMS 与早期死亡率（定义为受伤后 1 天内的死亡率）之间的关联。根据事件类型（军事或民用）或伤害类型（穿透性或非穿透性）进一步进行回归分析。

结果 

该研究共纳入 2344 名伤亡人员，其中 756 人（32.3%）通过空运撤离。GEMS 和 HEMS 组的早期死亡率分别为 90/1588 (5.7%) 和 37/756 (4.9%)。回归分析发现 HEMS 和早期死亡率之间没有显着分析 [OR, 0.86 (95% CI, 0.57–1.26)]。按事件类型分层，战斗[OR，1.69（95% CI，0.79–3.92）]和非战斗[OR，0.73（95% CI，0.4–1.25）]事件证明HEMS与早期死亡率之间不存在显着相关性。HEMS 与穿透性损伤伤员早期死亡率降低相关[OR, 0.59 (95% CI, 0.34–0.98)]，但与非穿透性损伤伤员早期死亡率无关[OR, 0.84 (95% CI, 0.43– 1.52）]。

结论 

在这项涵盖院前和医院场景的研究中，HEMS 与创伤伤员早期死亡率的降低无关。穿透伤死亡率呈现积极趋势并下降。需要进一步研究以确定哪些伤员受益于 HEMS，这将有助于更精确地利用这一昂贵的资源。