Long-term follow-up of trauma patients before and after implementation of a physician-staffed helicopter: A prospective observational study

详细信息    查看全文

• 作者：Kamilia S. Funder^a ; ^{milafun@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Lars S. Rasmussen^a ; Nicolai Lohse^b ; Volkert Siersma^c ; Rasmus Hesselfeldt^a ; Jacob Steinmetz^a
• 关键词：Trauma care ; Return to work ; Helicopter emergency medical system ; Health economics
• 刊名：Injury
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：47
• 期：1
• 页码：7-13
• 全文大小：495 K

文摘

The first Danish Helicopter Emergency Medical Service (HEMS) was introduced May 1st 2010. The implementation was associated with lower 30-day mortality in severely injured patients. The aim of this study was to assess the long-term effects of HEMS on labour market affiliation and mortality of trauma patients.

d="absSec_2">Methods

d="spar0010">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.

d="absSec_3">Results

d="spar0015">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).

d="absSec_4">Conclusions

d="spar0020">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.