Evidence map›Paper›PMID 26771462›Full record

ArticlePloS one2016

Impact of Helicopter Emergency Medical Service in Traumatized Patients: Which Patient Benefits Most?

Hagen Andruszkow, Uwe Schweigkofler, Rolf Lefering, Magnus Frey, Klemens Horst, Roman Pfeifer, Stefan Kurt Beckers, Hans-Christoph Pape, Frank Hildebrand

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03940443 (Differences in Mortality and Morbidity in Patients Suffering a Time-critical Condition Between Ground Emergency Medical Services and Helicopter Emergency Medical Services - a Descriptive and Comparative Study), which is not on this map. Cited by 32 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03940443 unknown statusnot on this mapstarted 2019, after this paper: background citation

Differences in Mortality and Morbidity in Patients Suffering a Time-critical Condition Between Ground Emergency Medical Services and Helicopter Emergency Medical Services - a Descriptive and Comparative Study

TypeobservationalSponsorDalarna County Council, SwedenRan2019 to 2021Enrolled2,000ConditionsAmbulances, Traumatic Brain Injury, Acute Myocardial Infarction
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. 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 · 2026
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Observational
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hagen AndruszkowDepartment of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Uwe SchweigkoflerDepartment of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, 60389 Frankfurt am Main, Germany.
Rolf LeferingInstitute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Ostmerheimer Str. 200, 51109 Cologne, Germany.
Magnus FreyDepartment of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Klemens HorstDepartment of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Roman PfeiferDepartment of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Stefan Kurt BeckersEmergency Medical Service Aachen, Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen University, Pauwelsstraße 30, Germany.
Hans-Christoph PapeDepartment of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Frank HildebrandDepartment of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Helicopter Emergency Medical Service (HEMS) was established for the prehospital trauma care of patients. Improved rescue times and increased coverage areas are discussed as specific advantages of HEMS. We recently found evidence that HEMS exerts beneficial effects on outcomes for severely injured patients. However, it still remains unknown which group of trauma patients might benefit most from HEMS rescue. Consequently, the unique aim of this study was to reveal which patients might benefit most from HEMS rescue.

methodsTrauma patients (ISS ≥9) primarily treated by HEMS or ground emergency medical services (GEMS) between 2002 and 2012 were analysed using the TraumaRegister DGU. A multivariate regression analysis was used to reveal the survival benefit between different trauma populations.

resultsThe study included 52 281 trauma patients. Of these, 68.8% (35 974) were rescued by GEMS and 31.2% (16 307) by HEMS. HEMS patients were more severely injured compared to GEMS patients (ISS: HEMS 24.8±13.5 vs. GEMS 21.7±18.0) and more frequently suffered traumatic shock (SBP sys <90mmHg: HEMS 18.3% vs. GEMS 14.8%). However, logistic regression analysis revealed that HEMS rescues resulted in an overall survival benefit compared to GEMS (OR 0.81, 95% CI [0.75-0.87], p<0.001, Nagelkerke's R squared 0.526, area under the ROC curve 0.922, 95% CI [0.919-0.925]). Analysis of specific subgroups demonstrated that patients aged older than 55 years (OR 0.62, 95% CI [0.50-0.77]) had the highest survival benefit after HEMS treatment. Furthermore, HEMS rescue had the most significant impact after 'low falls' (OR 0.68, 95% CI [0.55-0.84]) and in the case of minor severity injuries (ISS 9-15) (OR 0.66, 95% CI [0.49-0.88]).

conclusionsIn general, trauma patients benefit from HEMS rescue with in-hospital survival as the main outcome parameter. Focusing on special subgroups, middle aged and older patients, low-energy trauma, and minor severity injuries had the highest survival benefit when rescued by HEMS. Further studies are required to determine the potential reasons of this benefit.

Indexed as

Multiple TraumaAdultAgedAir AmbulancesAircraftEmergency Medical ServicesFemaleHumansMaleMiddle AgedProspective StudiesSurvival AnalysisTrauma CentersYoung Adult

Identifiers

PMID26771462
PMCPMC4714808

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.