Long-term follow-up of trauma patients before and after implementation of a Physician-Staffed Helicopter

Methods: Prospective, observational study with a maximum follow-up time of 4.5 years. Trauma patients from a 5-month period prior to the implementation of HEMS (pre-HEMS) were compared with patients from the first 12 months after implementation (post-HEMS). All analyses were adjusted for sex, age and Injury Severity Score. Results: Of the total 1994 patients, 1790 were eligible for mortality analyses and 1172 ( n = 297 pre- HEMS and n = 875 post-HEMS) for labour market analyses. Incidence rates of involuntary early retirement or death were 2.40 per 100 person-years pre-HEMS and 2.00 post-HEMS; corresponding to a hazard ratio (HR) of 0.72 (95% confidence interval (CI) 0.44–1.17; p = 0.18). The HR of involuntary early retirement was 0.79 (95% CI 0.44–1.43; p = 0.43). The prevalence of reduced work ability after three years were 21.4% vs. 17.7%, odds ratio (OR) = 0.78 (CI 0.53–1.14; p = 0.20). The proportions of patients on social transfer payments at least half the time during the three-year period were 30.5% vs. 23.4%, OR = 0.68 (CI 0.49–0.96; p = 0.03). HR for mortality was 0.92 (CI 0.62–1.35; p = 0.66). Conclusions: The implementation of HEMS was associated with a significant reduction in time on social transfer payments. No significant differences were found in involuntary early retirement rate, long-term mortality, or work ability. (cid:2)

[1]  M. Bard,et al.  When birds can’t fly: An analysis of interfacility ground transport using advanced life support when helicopter emergency medical service is unavailable , 2014, The journal of trauma and acute care surgery.

[2]  D. Saitoh,et al.  Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan , 2014, Critical Care.

[3]  E. Aaviksoo,et al.  Sickness benefit cuts mainly affect blue-collar workers , 2014, Scandinavian journal of public health.

[4]  C. Krettek,et al.  Survival benefit of helicopter emergency medical services compared to ground emergency medical services in traumatized patients , 2013, Critical Care.

[5]  R. Hesselfeldt,et al.  Impact of a physician-staffed helicopter on a regional trauma system: a prospective, controlled, observational study , 2013, Acta anaesthesiologica Scandinavica.

[6]  Samuel M. Galvagno,et al.  Helicopter emergency medical services for adults with major trauma. , 2013, The Cochrane database of systematic reviews.

[7]  K. Christensen,et al.  Impact of the severity of trauma on early retirement , 2014, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[8]  C. Jensen,et al.  Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality , 2012, BMC Public Health.

[9]  P. Pronovost,et al.  Original Contribution Association between Helicopter Vs Ground Emergency Medical Services and Survival for Adults with Major Trauma Downloaded From: Http://jama.jamanetwork.com/ by a Helsebiblioteket Gir Deg Tilgang Til Jama User on 05/31/2012 , 2022 .

[10]  S. Thomas,et al.  Helicopter EMS: Research Endpoints and Potential Benefits , 2011, Emergency medicine international.

[11]  H. Evans,et al.  Helicopter transport: help or hindrance? , 2011, Current opinion in critical care.

[12]  C. Pedersen,et al.  The Danish Civil Registration System , 2011, Scandinavian journal of public health.

[13]  Mark Faul,et al.  Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services , 2011, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[14]  A. Mykletun,et al.  Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study , 2011, BMC public health.

[15]  Julius D. Cheng,et al.  Helicopters and the civilian trauma system: national utilization patterns demonstrate improved outcomes after traumatic injury. , 2010, The Journal of trauma.

[16]  K. Willett,et al.  Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence , 2010, Emergency Medicine Journal.

[17]  Roderick J McClure,et al.  A systematic review of early prognostic factors for return to work following acute orthopaedic trauma. , 2010, Injury.

[18]  F. Amsler,et al.  Factors associated with reduced longer-term capacity to work in patients after polytrauma: a Swiss trauma center experience. , 2010, Journal of the American College of Surgeons.

[19]  R. McClure,et al.  Determinants of return to work following non life threatening acute orthopaedic trauma: a prospective cohort study. , 2010, Journal of rehabilitation medicine.

[20]  R. Lavery,et al.  A fate worse than death? Long-term outcome of trauma patients admitted to the surgical intensive care unit. , 2009, The Journal of trauma.

[21]  J. H. Andersen,et al.  Register-based follow-up of social benefits and other transfer payments: Accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey , 2007, Scandinavian journal of public health.

[22]  Alex D. Mitchell,et al.  Air versus ground transport of major trauma patients to a tertiary trauma centre: a province-wide comparison using TRISS analysis. , 2005, Canadian journal of surgery. Journal canadien de chirurgie.

[23]  M. Swiontkowski,et al.  Early predictors of long-term work disability after major limb trauma. , 2006, The Journal of trauma.

[24]  E. Steyerberg,et al.  Prevalence and determinants of disabilities and return to work after major trauma. , 2005, The Journal of trauma.

[25]  H. Bøggild,et al.  [Socioeconomic risk indicators for disability pension within the Danish workforce. A registry-based cohort study of the period 1994-1998]. , 2003, Ugeskrift for laeger.

[26]  D. Boot,et al.  Disability after severe injury: five year follow up of a large cohort. , 1998, Injury.

[27]  J H Siegel,et al.  Factors influencing return to work following hospitalization for traumatic injury. , 1987, American journal of public health.

[28]  W. Baxt,et al.  Hospital-based rotorcraft aeromedical emergency care services and trauma mortality: a multicenter study. , 1985, Annals of emergency medicine.