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During a 2-year period, 445 trauma patients were transported directly from the scene by helicopter to a trauma center. The Glasgow Outcome Scale and a work status scale were used to evaluate followup information gathered 6 months to 2 1/2 years after the incident. Findings were cross-tabulated with Injury Severity Score (ISS) categories. Seventy-two per cent of the patients had an ISS greater than 15. The overall mortality was 26.1%. Twenty-seven patients (6.1%) were lost to followup. Eighty-three per cent of the patients made a good recovery and 75% returned to their former work status (job, school, or household duties). Of the followed survivors, 5.6% had severe disability and 2.0% were permanently institutionalized. No one remained in permanent vegetative state after 6 months. In a second followup period (3 to 4 years after incident) half of the patients contacted who were not working during the first followup period had either returned to their former work status or were currently trying to reenter the work force.Most survivors of serious injury benefit from an integrated trauma system as measured by their good recovery and the ability to return to work. Few patients remain severely disabled or vegetative, requiring permanent institutionalization.