title: Helicopter emergency medical services and stroke care regionalization: measuring performance in a maturing system.
abstract: This study retrospectively analyzed 123 patients undergoing helicopter emergency medical services transport for ischemic stroke (ischemic cerebrovascular accident) to the Massachusetts General Hospital during 2000-2004. To assess for system improvements over time, data were analyzed between the 2 consecutive 30-month periods comprising the 5-year study. Patients transported during the latter 30 months were transported from lesser distances (P = .002), were more likely to be younger than 65 years (P = .005), and were more likely to have documented symptom onset time (P = .03) and National Institutes of Health Stroke Scale (odds ratio, 3.6; 95% confidence interval, 1.7-7.6; P = .001). Time end points analysis found no significant improvements in any intervals compared across the 2 study eras. Age older than 65 years was the only covariate associated with a more rapid arrival at the Massachusetts General Hospital (odds ratio, 2.4; 95% CI, 1.1-5.4; P = .03). This study of our stroke transport system identified both areas of good performance and also areas for focusing further improvement efforts.
authors.affiliation: Harvard Affiliated Emergency Medicine Residency, Boston, MA 02114, USA.
authors.forename: Wendy Macias
authors.initials: WM
authors.lastname: Konstantopoulos
authors.forename: John
authors.initials: J
authors.lastname: Pliakas
authors.forename: Christine
authors.initials: C
authors.lastname: Hong
authors.forename: Katie
authors.initials: K
authors.lastname: Chan
authors.forename: Gina
authors.initials: G
authors.lastname: Kim
authors.forename: Lauren
authors.initials: L
authors.lastname: Nentwich
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D013997:Time Factors