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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2017

Open Access 01-12-2017 | Original research

The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study

Authors: Kamilia S. Funder, Lars S. Rasmussen, Nicolai Lohse, Rasmus Hesselfeldt, Volkert Siersma, Jesper Gyllenborg, Sandra Wulffeld, Ole M. Hendriksen, Freddy K. Lippert, Jacob Steinmetz

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2017

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Abstract

Background

Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit.

Methods

Prospective, observational study with 5.5 years of follow-up. We included patients admitted to the stroke unit the first three years after implementation of a helicopter emergency medical services (HEMS) from a geographical area covered by both the HEMS and the ground emergency medical services (GEMS). HEMS patients were compared with GEMS patients. Primary outcome was long-term mortality after admission to the stroke unit.

Results

Of the 1679 patients admitted to the stroke unit, 1068 were eligible for inclusion. Mortality rates were 9.04 per 100 person-years at risk (PYR) in GEMS patients and 9.71 per 100 PYR in HEMS patients (IRR = 1.09, 95% CI 0.79–1.49; p = 0.60). The 30-day mortality was 7.4% with GEMS and 7.9% with HEMS (OR = 1.02, CI 0.53–1.96; p = 0.96). Incidence rate of involuntary early retirement was 6.97 per 100 PYR and 7.58 per 100 PYR in GEMS and HEMS patients, respectively (IRR = 1.19, CI 0.27–5.26; p = 0.81). Work ability after 2 years and time on social transfer payments did not differ between groups. We found no significant difference in mean modified Rankin Scale score after 3 months (2.21 GEMS vs. 2.09 HEMS; adjusted mean difference = −0.20, CI −0.74–0.33; p = 0.46).

Discussion

The possible benefit of HEMS for neurological outcome is probably difficult to detect by considering mortality, but for the secondary analyses we had less statistical power as illustrated by the wide confidence intervals.

Conclusion

Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved labour market affiliation compared to patients transported by a ground unit.

Trial registration

The study was registered at ClinicalTrials.gov (NCT02576379).
Appendix
Available only for authorised users
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Metadata
Title
The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study
Authors
Kamilia S. Funder
Lars S. Rasmussen
Nicolai Lohse
Rasmus Hesselfeldt
Volkert Siersma
Jesper Gyllenborg
Sandra Wulffeld
Ole M. Hendriksen
Freddy K. Lippert
Jacob Steinmetz
Publication date
01-12-2017
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-017-0363-3

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