title: Helicopter transport of stroke patients and its influence on thrombolysis rates: data from the Austrian Stroke Unit Registry.
abstract: OBJECTIVE
  Acute stroke management requires minimization of prehospital time. This study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis.
  
  
  METHODS
  Prospective data collection and prespecified evaluation of data from 32 stroke units between 2003 and 2009 were used. We distinguished between patients transported either directly to a stroke unit or transferred indirectly via a peripheral hospital. Thus, there were 6 transport groups: helicopter emergency service (HEMS) direct and indirect, ambulance accompanied by an emergency physician direct and indirect, and ambulance without physician direct and indirect. Demographic and clinical factors, time delays, and rates of thrombolysis of patients transported by helicopter were compared with factors of patients transported otherwise.
  
  
  RESULTS
  Of 21 712 ischemic stroke patients, 905 patients (4.1%) were transported by helicopter. Of these, 752 patients (3.4%) were transported by direct HEMS, and 153 patients (0.7%) were transported by indirect HEMS. Thrombolysis rates were highest for HEMS (24% direct, 29% indirect) transport, followed by ambulance accompanied by an emergency physician (18% direct, 15% indirect). The probability of receiving thrombolysis was highest for indirect HEMS transport (OR 3.6, 2.2-6.0), followed by indirect ambulance accompanied by an emergency physician transport (OR 1.5, 1.1-1.9). The shortest times, 90 minutes or less from stroke onset to hospital arrival, were achieved with direct AMBP and direct HEMS transport.
  
  
  CONCLUSIONS
  The shortest hospital arrival times and highest thrombolysis rates were seen in ischemic stroke patients transported by helicopter.
authors: FESO, FAHA, Center of Clinical Neurosciences, Danube University Krems, Dr.-Karl-Dorrek-Str. 30, A-3500 Krems, Austria.
authors: Veronika
authors: V
authors: Reiner-Deitemyer
authors: Yvonne
authors: Y
authors: Teuschl
authors: Karl
authors: K
authors: Matz
authors: Martina
authors: M
authors: Reiter
authors: Raoul
authors: R
authors: Eckhardt
authors: Leonhard
authors: L
authors: Seyfang
authors: Claudia
authors: C
authors: Tatschl
authors: Michael
authors: M
authors: Brainin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000552:Ambulances / Q000706:statistics & numerical data; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome