title: Bleeding complications following initiation of thrombolytic therapy for acute myocardial infarction: a comparison of helicopter-transported and nontransported patients.
abstract: OBJECTIVE
  To evaluate the effect of helicopter transport of acute myocardial infarction (AMI) patients after initiation of thrombolysis on bleeding complications through hospital discharge.
  
  
  METHODS
  Prospectively identified incidence (cohort) study.
  
  
  METHODS
  Air medical service of tertiary-care teaching hospital.
  
  
  METHODS
  Ninety-five consecutive AMI patients transported within 12 hours of the initiation of thrombolysis with recombinant tissue-type plasminogen activator were compared with 119 nontransported AMI patients treated in a similar manner.
  
  
  RESULTS
  The transported and nontransported populations were similar with regard to age, sex, and infarct location. Transport was well tolerated with no episodes of cardiac arrest or cardioversion occurring during transport. Hypotension requiring fluids or increased pressors occurred in 18 patients. Bleeding complications of all types occurred in 43.2% of the transported and 49.6% of the nontransported patients, respectively (relative risk, 0.87; 95% confidence interval, 0.65 to 1.17).
  
  
  CONCLUSIONS
  Helicopter transport of AMI patients after initiation of thrombolysis appears to be safe acutely and without a clinically significant increase in risk of bleeding complications through hospital discharge when accomplished by a highly skilled team.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: R E
authors.initials: RE
authors.lastname: Fromm
authors.forename: E
authors.initials: E
authors.lastname: Hoskins
authors.forename: L
authors.initials: L
authors.lastname: Cronin
authors.forename: C M
authors.initials: CM
authors.lastname: Pratt
authors.forename: W H
authors.initials: WH
authors.lastname: Spencer
authors.forename: R
authors.initials: R
authors.lastname: Roberts
mesh_terms: D000401:Aircraft; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D012306:Risk; D013781:Texas; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use; D014187:Transportation of Patients / Q000592:standards*
chemical_list: D010959:Tissue Plasminogen Activator