Air Medical Prehospital Triage Score and Racial and Ethnic Disparities in Air Transport After Injury
Authors' conclusion
The results of this cohort study indicate that standard use of the AMPT score during air medical triage may improve equity in prehospital AMT use.
Study context
- Population
- Injured patients aged ≥16 y transported by ground or helicopter EMS from the scene, transport distance ≥5 miles, Pennsylvania Trauma Outcomes Study, 2000–2020
- Participants
- 307,831 patients
- Exposure
- Air Medical Prehospital Triage (AMPT)-assigned vs actual prehospital transport mode (air vs ground), by race and ethnicity
- Non-Hispanic Asiann = 2,727
- Non-Hispanic Blackn = 30,570
- Hispanic/Latinon = 8,471
- Non-Hispanic Whiten = 253,491reference
- Othern = 4,643
- Outcome
- Actual prehospital transport mode (air vs ground) and AMPT-assigned transport mode; in-hospital mortality by AMPT triage assignment
Methodological detailsregistry database, causal mediation analysis
- Registry database
- Causal mediation analysis
Main finding
As reported in the abstract
Prehospital AMT use by race and ethnicity
- Non-Hispanic Asian, Non-Hispanic Black and Hispanic/Latino patients significantly less likely to undergo prehospital air medical transport (AMT) vs White patients (actual transport)
- With AMPT-assigned transport mode, no significant associations between race and ethnicity and AMT use
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| In-hospital mortality, air vs ground transport, AMPT score ≥224% lower odds of mortality | 0.76 (0.58–0.99) | P = 0.40 | |
| 0.512Adjusted odds ratio (log scale) |
Socioenvironmental context (Area Deprivation Index (ADI), Distressed Communities Index (DCI), Social Deprivation Index (SDI))
- Proportion of effect of race and ethnicity on transport mode mediated by ADI
- 38% (mediation effect 0.38; 95% CI 0.35-0.42)
- Proportion mediated by DCI
- 40% (mediation effect 0.40; 95% CI 0.38-0.43)
- Proportion mediated by SDI
- 13% (mediation effect 0.13; 95% CI 0.11-0.18)
- As ADI, DCI and SDI scores increased, AMT use varied by race and ethnicity
- Causal mediation analyses
Original publication
Air Medical Prehospital Triage Score and Racial and Ethnic Disparities in Air Transport After Injury. JAMA Surg. Published 1 January 2026. doi:10.
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