Socioeconomic equity measured by Indices of Multiple Deprivation for HEMS-attended major trauma in South East England: heterogenous effects in severe traumatic brain injury.

Griggs J, Harris J, Barrett J, +5 more, Lyon R.

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

Among 1,752 HEMS-attended major trauma patients in South East England, 30-day mortality did not differ across socioeconomic deprivation quintiles, and intervention delivery was equitable.

What was studied

A retrospective service evaluation of consecutive HEMS-attended major trauma patients (ISS >15) in Kent, Surrey, and Sussex (2013-2022), using incident-location deprivation indices.

Key findings

Median ISS 27.
30-day mortality 17% in least deprived vs 21% in most deprived (p=0.861); adjusted OR per quintile 1.01.
Prehospital anesthesia 37-43%, blood 8-13%, night operations 28-41%, with no significant differences.
Exploratory GCS by deprivation interaction in TBI (p=0.003).

Clinical relevance

This suggests regional HEMS can deliver equitable trauma care across deprivation levels, though deprivation was measured by incident location rather than residence.

Who should care

Emergency Medicine

Limitations

Service evaluation using incident location rather than residence; exploratory subgroup findings.

Air ambulance trauma care delivered similar survival across rich and poor areas in this region.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

Healthcare inequalities persist across socioeconomic gradients with deprived populations experiencing higher trauma mortality. This study aimed to determine whether 30-day mortality differs across socioeconomic deprivation quintiles in Helicopter Emergency Medical Service (HEMS) attended major trauma and to assess equity of intervention delivery and operational response.

Methods

Retrospective service evaluation cohort study of consecutive HEMS-attended major trauma patients (Injury Severity Score (ISS)>15) by Air Ambulance Charity Kent Surrey and Sussex (July 2013-February 2022). Indices of Multiple Deprivation quintiles derived from preassigned Lower Layer Super Output Area (LSOA) at incident location rather than patient residential address were examined alongside mortality outcomes. The primary outcome was 30-day mortality across socioeconomic quintiles (Q), with prespecified subgroups including traumatic haemorrhage and traumatic brain injury (TBI). Geospatial analysis and multivariable logistic regression were performed.

Results

Among 1752 major trauma patients (median ISS 27, IQR 21-36) geospatial analysis identified missions in 1190 LSOA codes (10.5% of region), with clustering in areas of moderate deprivation. 30-day mortality showed no socioeconomic gradient: 17% (95% CI 12% to 25%) in Q1 vs 21% (95% CI 17% to 25%) in Q5, p=0.861. Multivariable logistic regression confirmed no independent association between deprivation and mortality (adjusted OR per quintile increase 1.01, 95% CI 0.92 to 1.11, p=0.800). Secondary outcomes demonstrated equitable service provision with prehospital emergency anaesthesia 37-43% (p=0.667), blood transfusion 8-13% (p=0.321) and night operations 28-41% (p=0.124). Exploratory subgroup analysis identified a significant Glasgow Coma Scale×deprivation interaction in TBI (p=0.003), with possible age-dependent variations warranting further investigation.

Conclusions

Equitable 30-day mortality outcomes were achieved across socioeconomic quintiles within the operational region examined. A regional HEMS may mitigate health inequalities in major trauma, though complete equity requires addressing broader social determinants of health.

DOI

10.1136/emermed-2025-215619

PMID

42521477

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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