Identifying patients transported by helicopter emergency medical services using the International Classification of Diseases (ICD)-11: a scoping review.

BACKGROUND

Helicopter emergency medical services (HEMS) are an imperative life-saving strategy globally. This study aimed to identify patients transported by HEMS using the International Classification of Diseases 11th version (ICD-11).

METHODS

A comprehensive search was conducted in PubMed, Web of Science, and PsycInfo to identify articles published in English between January 1, 2010, and February 26, 2025, that included at least 5 cases transported by HEMS. Studies were included if they reported trauma, non-trauma patients or both and for those with trauma, type of trauma and/or cause of trauma.

RESULTS

This scoping review included 91 studies involving 3,687,053 patients (range, 6 − 1,679,675 cases), with a median number of 1,562 male patients (standardized proportion 66.07%). Non-traumatic conditions accounted for 57.25% of global HEMS missions, while trauma represented 42.75%. Unlike other regions, North America had a higher incidence of trauma than disease. Among disease cases, cardiac arrest (MC82, 6.92%) was a frequently reported condition. Among the trauma cases, polytrauma (ND37, 1.45%) was the most common. The transport accidents, falls, and submersion represented the predominant trauma causes. Regarding trauma type, incidence of blunt trauma (26.30%) was more than five times that of penetrating trauma (5.03%).

CONCLUSIONS

This study identified the HEMS-transported patient profiles by the ICD-11 framework. We found significant heterogeneity and underreporting in the existing literatures, leading to several diseases and trauma being classified under non-specific ICD-11 codes, along with their causes and types. Future research should prioritize the collection and reporting of granular, specific diagnostic data to fully leverage the ICD-11 framework. This will be essential for improving patient outcomes in high-acuity pre-hospital care. CLINICAL TRIAL NUMBER: Not applicable.