Helicopter emergency medical services and stroke care regionalization: measuring performance in a maturing system.
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.
Konstantopoulos
Wendy Macias
WM
Harvard Affiliated Emergency Medicine Residency, Boston, MA 02114, USA.
Pliakas
John
J
Hong
Christine
C
Chan
Katie
K
Kim
Gina
G
Nentwich
Lauren
L
Thomas
Stephen H
SH
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