• Yoshihiro Kushida, Kei Jitsuiki, Ken-Ichi Muramatsu, Saya Ikegami, Hiroki Nagasawa, Ikuto Takeuchi, Hiromichi Ohsaka, Yasumasa Oode, Kazuhiko Omori, and Youichi Yanagawa.
• Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, 410-2295, Japan.
• Am J Emerg Med. 2021 Jul 1; 45: 358-360.

PurposeWe retrospectively investigated prognostic factors for severe thoracic trauma patients evacuated by a physician-staffed helicopter emergency medical service (HEMS) and ground ambulance using the Japan Trauma Data Bank (JTDB).MethodsThis study was a retrospective analysis of the JTDB database. The study period was from January 2004 to May 2019. The subjects were divided into two groups, according to the type of transportation: the Heli group included cases transported by the HEMS, while the Ambulance group included cases transported by ground ambulance.ResultsDuring the investigation period, a total of 57,872 patients were enrolled as subjects, including 7238 in the Heli group and 50,634 in the Ambulance group. The average age, male ratio, average injury severity score (ISS), average revised trauma score (RTS) and survival ratio were significantly greater in the Heli group than in the Ambulance group. After performing a propensity score-matched analysis, there were no statistical differences concerning the age, sex, ISS, RTS between the two groups. However, the survival ratio in the Heli group remained greater than that in the Ambulance group. When variables that showed statistical significance in the univariate analysis were included in a multivariate analysis, the RTS, transport by the HEMS, age, ISS and female gender were identified as significant predictors of a survival outcome. The HEMS was significantly associated with an increased survival ratio (odds ratio: 1.69; 95% confidence interval: 1.51-1.88) compared with a ground ambulance.ConclusionThe present study showed that transport by the HEMS improved the survival rate compared to that by a ground ambulance for patients with severe thoracic trauma.Copyright © 2020 Elsevier Inc. All rights reserved.

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