Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry

Abstract While both physician-staffed ground ambulances (GA) and air ambulances (AA) can function as viable transportation options in severe trauma cases, no study has directly compared their efficacies. We aimed to compare the effects of physician-staffed GA and AA on the outcomes of patients with...

Full description

Saved in:
Bibliographic Details
Main Authors: Tomohiro Akutsu, Akira Endo, Ryo Yamamoto, Kazuma Yamakawa, Hiraaki Okuzawa, Keisuke Suzuki, Hiromasa Hoshi, Yasuhiro Otomo, Koji Morishita
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-89489-w
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849723782806110208
author Tomohiro Akutsu
Akira Endo
Ryo Yamamoto
Kazuma Yamakawa
Hiraaki Okuzawa
Keisuke Suzuki
Hiromasa Hoshi
Yasuhiro Otomo
Koji Morishita
author_facet Tomohiro Akutsu
Akira Endo
Ryo Yamamoto
Kazuma Yamakawa
Hiraaki Okuzawa
Keisuke Suzuki
Hiromasa Hoshi
Yasuhiro Otomo
Koji Morishita
author_sort Tomohiro Akutsu
collection DOAJ
description Abstract While both physician-staffed ground ambulances (GA) and air ambulances (AA) can function as viable transportation options in severe trauma cases, no study has directly compared their efficacies. We aimed to compare the effects of physician-staffed GA and AA on the outcomes of patients with trauma. This retrospective cohort study used records from the Japan Trauma Data Bank collected between April 2004 and December 2021. Data from patients aged ≥ 15 years with an Injury Severity Score > 15, who were directly transferred from the injury scenes, were analyzed. Patients were categorized into two groups based on the transportation method: physician-staffed GA and AA. The primary outcome measure (in-hospital mortality) and secondary outcomes (time to emergency department arrival, time to physician contact and prehospital treatment) were compared between the propensity score-matched groups. Of the 3,508 propensity score-matched pairs, the AA group exhibited significantly lower in-hospital mortality (810 [23.0%]) than the GA group (894 [25.4%]), odds ratio: 0.88 (95% confidence interval [CI] 0.79–0.98). Time to emergency department was significantly longer in the AA group than in the GA group. While patients in the GA group were likely to receive more treatments during transportation, patients in the AA group were likely to receive more surgical interventions after hospital arrival.
format Article
id doaj-art-2e5e84e87c634cd19e317135377a72e1
institution DOAJ
issn 2045-2322
language English
publishDate 2025-02-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-2e5e84e87c634cd19e317135377a72e12025-08-20T03:10:55ZengNature PortfolioScientific Reports2045-23222025-02-011511710.1038/s41598-025-89489-wMortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registryTomohiro Akutsu0Akira Endo1Ryo Yamamoto2Kazuma Yamakawa3Hiraaki Okuzawa4Keisuke Suzuki5Hiromasa Hoshi6Yasuhiro Otomo7Koji Morishita8Department of Trauma and Acute Care Surgery, Division of Acute Critical Care Medicine, Tsuchiura Kyodo General HospitalDepartment of Trauma and Acute Care Surgery, Division of Acute Critical Care Medicine, Tsuchiura Kyodo General HospitalDepartment of Emergency and Critical Care Medicine, Keio University School of MedicineDepartment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical UniversityDepartment of Trauma and Acute Care Surgery, Division of Acute Critical Care Medicine, Tsuchiura Kyodo General HospitalDepartment of Trauma and Acute Care Surgery, Division of Acute Critical Care Medicine, Tsuchiura Kyodo General HospitalDepartment of Trauma and Acute Care Surgery, Division of Acute Critical Care Medicine, Tsuchiura Kyodo General HospitalNational Hospital Organization (NHO) Disaster Medical CenterDepartment of Acute Critical Care and Disaster Medicine, Graduate School of Medicine and Dental Sciences, Tokyo Medical and Dental UniversityAbstract While both physician-staffed ground ambulances (GA) and air ambulances (AA) can function as viable transportation options in severe trauma cases, no study has directly compared their efficacies. We aimed to compare the effects of physician-staffed GA and AA on the outcomes of patients with trauma. This retrospective cohort study used records from the Japan Trauma Data Bank collected between April 2004 and December 2021. Data from patients aged ≥ 15 years with an Injury Severity Score > 15, who were directly transferred from the injury scenes, were analyzed. Patients were categorized into two groups based on the transportation method: physician-staffed GA and AA. The primary outcome measure (in-hospital mortality) and secondary outcomes (time to emergency department arrival, time to physician contact and prehospital treatment) were compared between the propensity score-matched groups. Of the 3,508 propensity score-matched pairs, the AA group exhibited significantly lower in-hospital mortality (810 [23.0%]) than the GA group (894 [25.4%]), odds ratio: 0.88 (95% confidence interval [CI] 0.79–0.98). Time to emergency department was significantly longer in the AA group than in the GA group. While patients in the GA group were likely to receive more treatments during transportation, patients in the AA group were likely to receive more surgical interventions after hospital arrival.https://doi.org/10.1038/s41598-025-89489-wEmergency medical serviceHelicopterInjuryPrehospital careTrauma
spellingShingle Tomohiro Akutsu
Akira Endo
Ryo Yamamoto
Kazuma Yamakawa
Hiraaki Okuzawa
Keisuke Suzuki
Hiromasa Hoshi
Yasuhiro Otomo
Koji Morishita
Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry
Scientific Reports
Emergency medical service
Helicopter
Injury
Prehospital care
Trauma
title Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry
title_full Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry
title_fullStr Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry
title_full_unstemmed Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry
title_short Mortality rates in physician staffed ground vs. air ambulance for severe trauma patients: retrospective analysis of the Japanese nationwide trauma registry
title_sort mortality rates in physician staffed ground vs air ambulance for severe trauma patients retrospective analysis of the japanese nationwide trauma registry
topic Emergency medical service
Helicopter
Injury
Prehospital care
Trauma
url https://doi.org/10.1038/s41598-025-89489-w
work_keys_str_mv AT tomohiroakutsu mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT akiraendo mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT ryoyamamoto mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT kazumayamakawa mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT hiraakiokuzawa mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT keisukesuzuki mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT hiromasahoshi mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT yasuhirootomo mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry
AT kojimorishita mortalityratesinphysicianstaffedgroundvsairambulanceforseveretraumapatientsretrospectiveanalysisofthejapanesenationwidetraumaregistry