Trends in Varying Modes of Hospital Arrival: What Determines the Ideal Mode of Transportation?

Introduction Modes of transportation to hospitals can significantly alter the morbidity and mortality rates of medical emergencies. Identifying different modes of transportation as risk factors for mortality in emergency room (ER) visits can enhance understanding of safety. This study aimed to investigate the relationship between modes of transportation and mortality and to see how trends in various patient factors change over time. Methods A retrospective analysis was conducted utilizing data from the National Trauma Data Bank (NTDB) from 2012 to 2022. The study consisted of patients who arrived at an emergency room. Data regarding different modes of arrival and mortality outcome were queried, along with additional variables including patient age, sex, length of stay (LOS), injury severity score (ISS), and hospital discharge disposition. Chi-square analysis was performed to assess the independent association between these variables. Results A total of 11,716,771 patients were included. The mode of transportation among those who expired was as follows: 75.64% (215,059 patients) used ground ambulance, 20.66% (58,746 patients) used helicopter emergency medical services (HEMS), 2.63% (7,488 patients) used private/public vehicle/walk-ins, 0.71% (2,007 patients) used fixed-wing ambulance, and 0.36% (1,035 patients) used police. After adjustment for covariates, the analysis revealed a statistically significant (p<0.001) association across all years. The transportation mode with the highest percentage of total deaths across all years was helicopter ambulance (6.84%), followed by fixed-wing ambulance (4.28%) and ground ambulance (2.46%). Mortality rate and LOS increased across all modes of transportation from 2012 to 2022, except for police transports, which experienced decreased rates. Conclusion These data suggest that certain modes of transportation may face increased mortality risk, with the highest percentage of deaths from helicopter ambulance. With increased usage of certain modes of transportation over time, it allows us to question whether such transportation modes are justified by risk and cost. Further research is warranted to elucidate the underlying mechanisms contributing to these disparities.