Effect of Helicopter Transportation of Acute Ischemic Stroke Patients on Mortality and Functional Outcomes: A Systematic Review and Meta-Analysis

Florez-Perdomo, William A.; García-Ballestas, Ezequiel; Konar, Subhas; Ramos-Gomez, Lucia; Al‐Mufti, Fawaz; Sursal, Tolga; Munakomi, Sunil; Agrawal, Amit; Moscote-Salazar, Luís Rafael

doi:10.1016/j.amj.2022.07.001

Cited by 12 publications

(3 citation statements)

References 28 publications

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“…HEMS also provides care that can result in shorter hospitalizations and quicker recovery for patients who might survive without EMS support or air transport. Research on this topic is still quite scarce and more detailed comparative studies are needed [ 55 ]. On the other hand, some patients may survive but continue living with severe disability.…”

Section: Discussionmentioning

confidence: 99%

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

Ackermann,

Pappinen,

Nurmi

et al. 2024

Scand J Trauma Resusc Emerg Med

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Objectives Since Helicopter Emergency Medical Services (HEMS) is an expensive resource in terms of unit price compared to ground-based Emergency Medical Service (EMS), it is important to further investigate which methods would allow for the optimization of these services. The aim of this study was to evaluate the cost-effectiveness of physician-staffed HEMS compared to ground-based EMS in developed scenarios with improvements in triage, aviation performance, and the inclusion of ischemic stroke patients. Methods Incremental cost-effectiveness ratio (ICER) was assessed by comparing health outcomes and costs of HEMS versus ground-based EMS across six different scenarios. Estimated 30-day mortality and quality-adjusted life years (QALYs) were used to measure health benefits. Quality-of-Life (QoL) was assessed with EuroQoL instrument, and a one-way sensitivity analysis was carried out across different patient groups. Survival estimates were evaluated from the national FinnHEMS database, with cost analysis based on the most recent financial reports. Results The best outcome was achieved in Scenario 3.1 which included a reduction in over-alerts, aviation performance enhancement, and assessment of ischemic stroke patients. This scenario yielded 1077.07–1436.09 additional QALYs with an ICER of 33,703-44,937 €/QALY. This represented a 27.72% increase in the additional QALYs and a 21.05% reduction in the ICER compared to the current practice. Conclusions The cost-effectiveness of HEMS can be highly improved by adding stroke patients into the dispatch criteria, as the overall costs are fixed, and the cost-effectiveness is determined based on the utilization rate of capacity.

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Section: Discussionmentioning

confidence: 99%

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

Ackermann,

Pappinen,

Nurmi

et al. 2024

Scand J Trauma Resusc Emerg Med

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“…HEMS has a huge impact on saving lives in many types of emergencies, and even has uses in urban areas. A helicopter transport service has been used successfully to improve outcomes in emergency perinatal patients [ 26 ], in acute ischemic stroke patients (reduced disability after an ischemic stroke) [ 27 ], in traumatic patients, especially in a rural area [ 28 ], in paediatric emergencies [ 29 ], in patients with septic shock [ 30 ], in snake envenomation [ 31 ], and in patients with myocardial infarction [ 32 ]. Even critically ill COVID-19-positive patients can be successfully transferred by HEMS.…”

Section: Discussionmentioning

confidence: 99%

Emergency Air Transport of Patients with Acute Chest Pain in the Adriatic Islands of Croatia: A Four-Year Analysis

Zanic

Kovačić

Jukic

2023

IJERPH

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Background: An efficient first-aid system usually supports ground services with a helicopter emergency medical service (HEMS). An HEMS is important for patients with acute chest pain on remote islands. The current study sought to identify the characteristics of HEMS in acute chest pain cases on the Croatian Adriatic islands over a four-year period. Methods: We conducted a four-year observational study to investigate HEMS from Adriatic islands. The study population consisted of all patients with acute coronary syndrome or pulmonary embolisms who were urgently transferred by HEMS to the University Hospital in Split 1 June 2018–1 June 2022. Results: During the observation period, 222 adult patients (67 females, or 30.2%) were urgently transferred. The mean age was 71.81 ± 13.42 years. The most common diagnosis was ST-elevated myocardial infarction (113, 50.9%). Most of the HEMS cases were from Hvar (91, 41.0%). The mean call-to-flight time was 19.10 ± 10.94 min, and the total time from call to hospital was 68.50 ± 22.29 min. The total time from call to hospital was significantly correlated with call-to-flight time (r = 0.761, P < 0.001). Of the 222 participants, 5 (2.25%) were transported for more than 120 min, and 35 (15.8%) were transported for more than 90 min. Conclusion: This study provided a detailed insight into HEMS in the area of the Croatian Adriatic islands. The average time from the call to the helicopter taking off was 19.10 min. An increase in dispatching time has a significant impact on the prolongation of the total time for the hospital admission. Shortening the response time is critical to reducing hospital arrival time.

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“…El transporte en helicóptero es menos frecuente y tiene características propias: mucho más caro, puede ahorrar tiempo en largas distancias, disponible solo cuando hay luz y la meteorología es favorable y está medicalizado, pero es difícil el tratamiento durante el vuelo. El transporte en helicóptero parece reducir las secuelas del ictus pero no la mortalidad respecto al transporte en ambulancia 10 .…”

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On the feasibility and usefulness of basic life support ambulances in prehospital care for stroke: Does type of ambulance matter in acute stroke?

Trejo-Gabriel-Galán,

González-Bernal

2024

Emergencias

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Effect of Helicopter Transportation of Acute Ischemic Stroke Patients on Mortality and Functional Outcomes: A Systematic Review and Meta-Analysis

Cited by 12 publications

References 28 publications

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

Emergency Air Transport of Patients with Acute Chest Pain in the Adriatic Islands of Croatia: A Four-Year Analysis

On the feasibility and usefulness of basic life support ambulances in prehospital care for stroke: Does type of ambulance matter in acute stroke?

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