What is the clinical evidence from this study?

Study design: Observational. Population: ST Elevation myocardial infarction (STEMI) (n=91). Intervention: Hospital A (longer helipad-to-PCI lab distance) vs. Hospital B (shorter helipad-to-PCI lab distance). Primary outcome: Time from helicopter air ambulance arrival at the PCI hospital helipad to the cardiac catheterization laboratory (p=<.001).

February 28, 2026

Physical Distance Between the Helipad and Cardiac Catheterization Laboratory: A Cause for Delay in Helicopter Air Ambulance Activated Patients with STEMI

Q: What are the key findings of this study?

Greater physical distance between the helipad and PCI laboratory significantly increased helipad-to-lab transit time for STEMI patients (11.0 vs 5.4 minutes; P<.001).

Q: What question did this study set out to answer?

This research examines how the physical distance between the helipad and PCI laboratory impacts delay times for STEMI treatment.

Key Result

Greater physical distance between the helipad and PCI laboratory significantly increased helipad-to-lab transit time for STEMI patients (11.0 vs 5.4 minutes; P<.001).

Key Points

This research examines how the physical distance between the helipad and PCI laboratory impacts delay times for STEMI treatment.
Retrospective chart review of STEMI patients transported by HAA from January 1, 2020, to January 1, 2023.
Data from two PCI hospitals were analyzed, comparing DDBT and time from helipad arrival to catheterization lab.
Descriptive statistics were utilized to evaluate differences in times between hospitals.
Data for 91 STEMI cases showed a median DDBT of 89.9 minutes and a median helipad to catheterization lab time of 10.5 minutes.
76% of cases were from hospital A and 24% from hospital B with no significant difference in DDBT times (P = .47).
Hospital A had significantly longer helipad-to-lab times (11.0 minutes) compared to hospital B (5.4 minutes; P < .001).

Study Design

Type

Observational (n=91)

Multicenter

Yes

Structured PICO

Does the physical distance between the helipad and cardiac catheterization laboratory increase transport time in STEMI patients?

Population

91 STEMI patients transported via helicopter air ambulance (HAA) from remote community hospitals to 2 PCI facilities

Intervention

Transport to Hospital A (longer physical distance between helipad and PCI laboratory)

Comparator

Transport to Hospital B (shorter physical distance between helipad and PCI laboratory)

Outcome

Door-to-door-to-balloon time (DDBT) and time from HAA arrival at the PCI hospital helipad to the cardiac catheterization laboratorysurrogate

The physical distance between a hospital's helipad and its cardiac catheterization laboratory significantly adds to the ischemic time for STEMI patients transported by air ambulance.

Main Result

Absolute Event Rate: 11% vs 5.4%

p-value: p=<.001

Abstract

OBJECTIVE: Decreased time to cardiac catheterization improves survival and limits cardiac tissue damage in ST Elevation myocardial infarction (STEMI). Emergency medical services delays account for half of treatment delays in STEMI. Helicopter air ambulance (HAA) can reduce the time to percutaneous intervention (PCI), and therefore may reduce mortality. The impact of physical distance between the PCI hospital helipad and the PCI laboratory on the door-to-door-to-balloon time (DDBT) for cardiac intervention in STEMI patients transported through HAA from remote community hospitals to PCI facilities was assessed. METHODS: This was a retrospective chart review of interfacility STEMI patients where HAA was activated to reduce DDBT from January 1, 2020, to January 1, 2023. The HAA agency under review transports STEMI patients to 2 PCI centers. There is a significant difference in the distance between the helipad and the PCI laboratory at the 2 hospitals. Descriptive statistics were used to compare DDBT as well as the time from HAA arrival at the PCI hospital helipad to the cardiac catheterization laboratory. RESULTS: Data were available for 91 STEMI cases. The median time for DDBT was 89.9 minutes with a median time of 10.5 minutes from helipad arrival to catheterization laboratory (Table 1). Of the 91 cases, 69 (76%) were from hospital A and 22 (24%) were from hospital B. There was no detectable difference in the distribution of DDBT times between hospitals (P = .47). Helipad arrival times to cardiac catheterization laboratory were significantly longer for hospital A than hospital B (P < .001). The median time for hospital A was 11.0 minutes (interquartile range, 9.2-14.0) compared with hospital B, which had a median of 5.4 minutes (5.0-7.3). CONCLUSION: The physical distance a PCI laboratory is located from the helipad can be a significant addition to ischemic time for STEMI patients.

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