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PP43 Investigating factors that affect mortality in patients presenting with head injuries to helicopter emergency medical services (HEMS): cross sectional study
  1. Jade Livingstone1,
  2. Jasmine Kirk2,
  3. Niro Siriwardena3,
  4. Graham Law4,
  5. Mehrshad Parvin Hosseini5,
  6. Shayda Karimi6,
  7. Anil Hormis7
  1. 1Community and Health Research Unit (CaHRU), UK
  2. 2Lincoln Nottinghamshire Air Ambulance (LNAA), UK
  3. 3University of Lincoln, UK
  4. 4University of Nottingham, UK


Background Head trauma is a common cause of death for people aged up to 40 years old in the United Kingdom (UK). The effect of Helicopter Emergency Medical Services (HEMS) on outcomes from severe head injury have been inconclusive hence, further analysis of the effect of HEMS interventions is required to understand the relationship with mortality, while accounting for patient demographics, comorbidities, and timing of treatment. We aimed to investigate the outcomes of the HEMS response to head injuries in one region of the UK.

Method We used a cross sectional design using routine data from Lincolnshire Nottinghamshire Air Ambulance (LNAA) which operates in the East Midlands region of the UK. Forty-five patients, who met the inclusion criteria, presented to LNAA with head injuries between July 2019 and November 2022 before being transported to Queens Medical Centre. Data including patient demographics, mechanism of injury, associated diagnoses, timings, physiological measurements, and interventions delivered by air ambulance staff were collected from LNAA and Nottingham University Hospitals NHS Trust and linked. Data were analysed using descriptive statistics and multivariable models to quantify their association with mortality within 30 days of the incident using STATA version 17.

Results Increasing age was significantly associated with mortality (p = 0.01), as were oxygen saturation at first observation (p = 0.02) and handover (p = 0.04). Other patient characteristics (sex, weight), injury mechanism, comorbidities, physiological variables, or interventions were not associated with an improved or worse patient outcome.

Conclusion Older age was associated with mortality in patients with head injuries presenting to HEMS. Higher oxygen saturation levels were associated with a decrease in mortality. The small sample size may have led to a type II error which emphasises the need for future research using larger samples to investigate predictors of mortality in an air ambulance setting.

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