Injury mortality following the loss of air medical support for rural interhospital transport

Objectives: This study evaluated variation in mortality among interfacility transfers three years before and after discontinuation of a rotor-wing transport service. Methods: A retrospective cohort assessment was conducted among severely injured patients transferred from four rural hospitals to a single tertiary center in regions with continued versus discontinued rotor-wing service. Thirty-day mortality following discharge from the receiving tertiary facility served as the primary outcome measure. Results: Discontinuation of rotor-wing transport decreased interfacility transfers and increased transfer time. Transferred patients were four times more likely to die after (compared with before) rotor-wing service was discontinued (p = 0.05). No difference was noted in the region with continued rotor-wing service [odds ratio (OR) = 0.53, p = 0.47]. Conclusions: Injury mortality increased with loss of air transport for interfacility transfer in a rural area.