Adopting the pre-hospital index for interfacility helicopter transport: a proposal

Injury. 2003 Jan;34(1):3-11. doi: 10.1016/s0020-1383(02)00082-7.


Background: Interfacility helicopter transport is expensive without proven outcome benefit in trauma patients. Our objectives were to determine the fastest method of rural to urban interfacility transport, and develop a triage tool to identify patients most in need of rapid transport.

Methods: Retrospective cohort study. Adults ISS > or = 12 transported from January 1996 to December 1998. Transport time variables were compared between geographical zones. A pre-transport index (PTI) identified two patient cohorts in which outcome was assessed.

Results: Air ambulance was faster than ground transport, with helicopter overall superior to fixed-wing (< 225 km range). Seventy-two percent of patients with PTI < 4 (n = 196) had no outcome indicating severe injury versus 29% of the PTI > or = 4 cohort (n=151). Mortality for PTI<4 was 1.4% versus 22% for PTI > or = 4.

Conclusion: Interfacility helicopter transport of severely injured rural trauma patients was the overall fastest method within a 225 km range. PTI > 4 identifies patients most in need of this fast but expensive method of transport.

MeSH terms

  • Adult
  • Air Ambulances / economics*
  • Air Ambulances / statistics & numerical data
  • Ambulances / economics
  • Ambulances / statistics & numerical data
  • Cohort Studies
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care*
  • Patient Transfer / economics*
  • Patient Transfer / methods
  • Retrospective Studies
  • Rural Health Services
  • Time and Motion Studies
  • Trauma Severity Indices
  • Triage / methods*
  • United States
  • Urban Health Services
  • Wounds and Injuries