ArticleSurgery2016
Helicopter transport improves survival following injury in the absence of a time-saving advantage.
Article in Surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Transport and destination hospital for patients with suspected multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Survival and cost-effectiveness of helicopter versus ground emergency medical services: a systematic review and meta-analysis with meta-regression and trial sequential analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- Trial
- Electrostatic Discharge During Helicopter Hoist Operations: A Nationwide Prospective Study of the Norwegian Search and Rescue Service.Journal of the American College of Emergency Physicians open · 2026Article
- Helicopter Emergency Medical Services attendance is associated with favourable survival outcomes in major trauma: derivation and internal validation of prediction models in a regional trauma system.Emergency medicine journal : EMJ · 2026Observational
- Establishing a Consensus-Based Definition of Air Medical Transport Need for Rural Patients After Injury: Results from a Delphi Survey.Prehospital emergency care · 2026Article
- Trends in Varying Modes of Hospital Arrival: What Determines the Ideal Mode of Transportation?Cureus · 2025Article
- How many minutes matter: Association between time saved with air medical transport and survival in trauma patients.The journal of trauma and acute care surgery · 2025Article
- Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry.Scientific reports · 2025Article
- Trauma patient transport to hospital using helicopter emergency medical services or road ambulance in Sweden: a comparison of survival and prehospital time intervals.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Impact of a ground intermediate transport from the helicopter landing site at a hospital on transport duration and patient safety.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Comparing strategies for prehospital transport to specialty care after cardiac arrest.Resuscitation · 2023Article
- Air Rescue for Pediatric Trauma in a Metropolitan Region of Brazil: Profiles, Outcomes, and Overtriage Rates.Frontiers in pediatrics · 2022Article
- Factors affecting development of air ambulance base: A systematic review and thematic analysis.Journal of education and health promotion · 2021Review
- A Comparative Process Mining Analysis of Road Trauma Patient Pathways.International journal of environmental research and public health · 2020Article
- Article
- Association of Practitioner Interfacility Triage Performance With Outcomes for Severely Injured Patients With Fee-for-Service Medicare Insurance.JAMA surgery · 2019Article
- Loss of life years due to unavailable helicopter emergency medical service: a single base study from a rural area of Norway.Scandinavian journal of primary health care · 2019Article
- Helicopter versus ground ambulance: review of national database for outcomes in survival in transferred trauma patients in the USA.Trauma surgery & acute care open · 2019Article
- Treatment, transport, and primary care involvement when helicopter emergency medical services are inaccessible: a retrospective study.Scandinavian journal of primary health care · 2018Observational
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundAlthough survival benefits have been shown at the population level, it remains unclear what drives the outcome benefits for helicopter emergency medical services (HEMS) in trauma. Although speed is often cited as the vital factor of HEMS, we hypothesized a survival benefit would exist in the absence of a time savings over ground emergency medical services (GEMS). The objective was to examine the association of survival with HEMS compared with GEMS transport across similar prehospital transport times.
methodsWe used a retrospective cohort of scene HEMS and GEMS transports in the National Trauma Databank (2007-2012). Propensity score matching was used to match HEMS and GEMS subjects on the likelihood of HEMS transport. Subjects were stratified by prehospital transport times in 5-minute increments. Conditional logistic regression determined the association of HEMS with survival across prehospital transport times strata controlling for confounders. Transport distance was estimated from prehospital transport times and average HEMS/GEMS transport speeds.
resultsThere were 155,691 HEMS/GEMS pairs matched. HEMS had a survival benefit over GEMS for prehospital transport times between 6 and 30 minutes. This benefit ranged from a 46% increase in odds of survival between 26 and 30 minutes (adjusted odds ratio [AOR], 1.46; 95% CI, 1.11-1.93; P < .01) to an 80% increase in odds of survival between 16 and 20 minutes (AOR, 1.80; 95% CI, 1.51-2.14; P < .01). This prehospital transport times window corresponds to estimated transport distance between 14.3 and 71.3 miles for HEMS and 3.3 and 16.6 miles for GEMS.
conclusionWhen stratified by prehospital transport times, HEMS had a survival benefit concentrated in a window between 6 and 30 minutes. Because there was no time-savings advantage for HEMS, these findings may reflect care delivered by HEMS providers.
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