One year's trauma mortality experience at Brooke Army Medical Center: Is aeromedical transportation of trauma patients necessary?

The purpose of this study was to review whether air ambulance transportatio n of trauma patients to the Brooke Army Medical Center (BAMC) level I traum a center contributed to maintaining national mortality standards in the tra uma care of these patients. Aeromedical transportation is considered a stan dard-of-care component of regional trauma systems throughout the United Sta tes. Pooled trauma database information from 792 consecutive ambulance-tran sported trauma patients received at BAMC during the fiscal year from Octobe r 1, 1995, to September 30, 1996, were reviewed. The 792 trauma patients we re composed of 687 patients transported by ground ambulance and 105 patient s who received helicopter aeromedical evacuation. Aeromedical evacuation wa s associated with increased levels of prehospital medical care and faster t ransportation than ground ambulance service. The mortality rates (immediate , early, and late deaths) of both ambulance groups were compared with natio nal mortality standards using the internationally recognized Trauma and Inj ury Severity Score methodology, based on the Major Trauma Outcome Study in 1986 and validated in 1992, The Z test for independent populations demonstr ated no statistically significant difference between BAMC trauma mortality rates for either ambulance group compared with national trauma mortality ra tes. The results suggest that aeromedical evacuation of the more severely i njured patients farthest from the BAMC trauma center resulted in mortality rates that met national standards.