Abstract 10677: Erlier Reperfusion in Patients With St-elevation Myocardial Infarction by Use of Helicopter Compared to Ground Transportation
Background:In patients with ST-elevation myocardial infarction (STEMI) reperfusion therapy should be initiated as soon as possible. This study evaluated whether use of helicopter for transportation of patients with STEMI is associated with earlier initiation of reperfusion therapy.
Material and methods:The study population comprised patients with STEMI and symptoms >= 12 hours, who had primary percutaneous coronary intervention (PPCI) performed at Aarhus University Hospital in Skejby. Patients self-presenting, patients developing STEMI after admission and patients with a health care system delay (time from emergency call to PPCI) of more than 360 minutes were excluded. The study period ran from 1.1.2011 until 31.12.2011. A Danish national Helicopter Emergency Medical Service project was initiated 1.6.2011 for transportation of patients with time-critical illnesses, including STEMI.
Results:The study population comprised 398 patients, of whom 85% were field-triaged directly to the invasive center. The median system delay was 94 minutes among those field-triaged and 168 minutes among those initially admitted to a local hospital. Patients transported by ambulance and field-triaged were stratified into four groups according to transport distance from the scene of event to the invasive center: ≤25 km., 26-50 km., 51-75 km. and >75 km. For these groups, the median system delay was 78, 89, 99, and 141 minutes. Among patients transported by helicopter and field-triaged the estimated median transport distance by ground transportation was 115 km, and the median system delay was 107 minutes. Based on second order polynomial regression, it was estimated that patients with a transport distance of >60 km to the invasive center may benefit from helicopter transportation, and that transportation by helicopter is associated with a system delay of less than 120 minutes even at a transport distance up to 150 km.
Conclusion:The present study indicates that use of helicopter may be considered for field-triage of patients with STEMI to the invasive center when the transportation distance is more than 60 km. This may ensure that patients living up to 150 km. from the invasive center can be treated within 120 minutes of emergency call.
- © 2012 by American Heart Association, Inc.