Key result
Among STEMI patients treated by the Polish Helicopter Emergency Medical Service, rural dispatch was associated with higher rates of death compared to urban dispatch.
Why the study?
In acute STEMI, quick transport to a specialist center is vital for survival, prompting evaluation of Polish HEMS missions and utilization in urban versus rural areas.
Are there differences in the characteristics and outcomes of STEMI patients treated by Helicopter Emergency Medical Services in urban versus rural areas?
Observational (n=6,099)
Yes
Are there differences in the characteristics and outcomes of STEMI patients treated by Helicopter Emergency Medical Services in urban versus rural areas?
HEMS utilization for STEMI differs between rural and urban areas, with rural dispatches associated with higher rates of sudden cardiac arrest and death during the early therapeutic phase.
Answers are grounded in this paper and cite their sources.
Rural HEMS STEMI dispatches linked to higher SCA and death; hypothesis-generating for geographic disparities, should not yet change practice.
BACKGROUND: In patients with acute phase of ST‑segment elevation myocardial infarction (STEMI), quick transportation to a specialist therapeutic center is of utmost importance to increase the chances of surviving. AIMS: The objective of this study was to characterize the missions of the Polish Helicopter Emergency Medical Service (HEMS) to patients with STEMI in urban and rural areas and to assess the utilization of air ambulance support as part of an early stage of the therapeutic process. METHODS: This retrospective analysis included 6099 patients with STEMI treated by the Polish HEMS crews from January 2011 to December 2018. RESULTS: The study group included mainly men (68.9%) and persons aged 60 to 79 years (53.9%). The mean (SD) age of the entire group was 64.8 (11.9) years. The level of consciousness measured by the Glasgow Coma Scale score ranged from 13 to 15 (84.8% of patients), the mean (SD) Revised Trauma Score was 11.4 (1.9) points, and the mean (SD) number of points on the National Advisory Committee for Aeronautics scale was 4 (1). In rural areas, the Polish HEMS crews were more frequently dispatched to medical emergencies (99.3% vs 59.6%). Sudden cardiac arrest occurred more often in those areas (6% vs 3.8%), which resulted in the death of the patient (2.4% vs 0.4%; P <0.05 for both). CONCLUSIONS: There were differences in utilization of the Polish HEMS in patients with STEMI in urban and rural areas. The results demonstrated a positive impact of the utilization of HEMS in the early stages of the therapeutic process of these patients.
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Świeżewski et al. (2020) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=6,099). Rural location vs. Urban location was evaluated on Death (p=<0.05). Among STEMI patients treated by the Polish Helicopter Emergency Medical Service, rural dispatch was associated with higher rates of death compared to urban dispatch.
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