Introduction: Whether the costly resource of ai transportation in interfacility pediatric trauma transfers is appropriately utilized is unclear. Our objective was to evaluate differences in clinical outcomes of pediatric trauma patients following interfacility transfer by ground versus airlift transportation.
Methods: A matched cohort study was conducted among a population of severely injured pediatric trauma patients transferred from referring facilities, based on the trauma registry at a single pediatric trauma facility. Demographics, injury characteristics, clinical characteristics at arrival, and clinical outcomes were prospectively collected. Each patient transported by air was matched to a patient transported by ground based on age(±3 years), NISS(±5), injury mechanism, and distance from the place of injury to the hospital(±30) miles.
Results: A total of 273 air-transported patients were matched to ground-transported patients. After matching, air-transported patients had a higher injury severity score (p=0.0003), were more likely to have a Level-1 trauma team activation (p<0.0001), be admitted to the ICU from the ED (p=0.0030), and be intubated at the referring facility (p=0.0004). The only clinical outcome that differed between transport groups was hospital length of stay, which was two days longer on average for the air-transported patients (p=0.0240). However, there was no difference in regards to time to first procedure, ICU days, ventilator support days, and hospital disposition (including death).
Conclusion: Clinical outcomes for patients transported by air were no different than for patients transported by ground. Consequently, further investigation is required into more accurately identifying those patients who would benefit most from interfacility air transport.
