The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study

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Standard

The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit : a prospective observational study. / Funder, Kamilia S; Rasmussen, Lars S.; Lohse, Nicolai; Hesselfeldt, Rasmus; Siersma, Volkert; Gyllenborg, Jesper; Wulffeld, Sandra; Hendriksen, Ole M.; Lippert, Freddy K.; Steinmetz, Jacob.

I: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Bind 25, 18, 23.02.2017, s. 1-9.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Funder, KS, Rasmussen, LS, Lohse, N, Hesselfeldt, R, Siersma, V, Gyllenborg, J, Wulffeld, S, Hendriksen, OM, Lippert, FK & Steinmetz, J 2017, 'The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study', Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, bind 25, 18, s. 1-9. https://doi.org/10.1186/s13049-017-0363-3

APA

Funder, K. S., Rasmussen, L. S., Lohse, N., Hesselfeldt, R., Siersma, V., Gyllenborg, J., ... Steinmetz, J. (2017). The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 25, 1-9. [18]. https://doi.org/10.1186/s13049-017-0363-3

Vancouver

Funder KS, Rasmussen LS, Lohse N, Hesselfeldt R, Siersma V, Gyllenborg J o.a. The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2017 feb 23;25:1-9. 18. https://doi.org/10.1186/s13049-017-0363-3

Author

Funder, Kamilia S ; Rasmussen, Lars S. ; Lohse, Nicolai ; Hesselfeldt, Rasmus ; Siersma, Volkert ; Gyllenborg, Jesper ; Wulffeld, Sandra ; Hendriksen, Ole M. ; Lippert, Freddy K. ; Steinmetz, Jacob. / The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit : a prospective observational study. I: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2017 ; Bind 25. s. 1-9.

Bibtex

@article{e993e59b30bd4677aa5f2ec6e81752f5,
title = "The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study",
abstract = "Background: Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit.Methods:Prospective, observational study with 5.5 years of follow-up. We included patients admitted to the stroke unit the first three years after implementation of a helicopter emergency medical services (HEMS) from a geographical area covered by both the HEMS and the ground emergency medical services (GEMS). HEMS patients were compared with GEMS patients. Primary outcome was long-term mortality after admission to the stroke unit.Results:Of the 1679 patients admitted to the stroke unit, 1068 were eligible for inclusion. Mortality rates were 9.04 per 100 person-years at risk (PYR) in GEMS patients and 9.71 per 100 PYR in HEMS patients (IRR = 1.09, 95{\%} CI 0.79–1.49; p = 0.60). The 30-day mortality was 7.4{\%} with GEMS and 7.9{\%} with HEMS (OR = 1.02, CI 0.53–1.96; p = 0.96). Incidence rate of involuntary early retirement was 6.97 per 100 PYR and 7.58 per 100 PYR in GEMS and HEMS patients, respectively (IRR = 1.19, CI 0.27–5.26; p = 0.81). Work ability after 2 years and time on social transfer payments did not differ between groups. We found no significant difference in mean modified Rankin Scale score after 3 months (2.21 GEMS vs. 2.09 HEMS; adjusted mean difference = −0.20, CI −0.74–0.33; p = 0.46).Discussion:The possible benefit of HEMS for neurological outcome is probably difficult to detect by considering mortality, but for the secondary analyses we had less statistical power as illustrated by the wide confidence intervals.Conclusion:Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved labour market affiliation compared to patients transported by a ground unit.Trial registration:The study was registered at ClinicalTrials.gov (NCT02576379).",
keywords = "Helicopter emergency medical services, Stroke, Mortality, Labour market affiliation, Disability",
author = "Funder, {Kamilia S} and Rasmussen, {Lars S.} and Nicolai Lohse and Rasmus Hesselfeldt and Volkert Siersma and Jesper Gyllenborg and Sandra Wulffeld and Hendriksen, {Ole M.} and Lippert, {Freddy K.} and Jacob Steinmetz",
year = "2017",
month = "2",
day = "23",
doi = "10.1186/s13049-017-0363-3",
language = "English",
volume = "25",
pages = "1--9",
journal = "Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine",
issn = "1757-7241",
publisher = "BioMed Central",

}

RIS

TY - JOUR

T1 - The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit

T2 - a prospective observational study

AU - Funder, Kamilia S

AU - Rasmussen, Lars S.

AU - Lohse, Nicolai

AU - Hesselfeldt, Rasmus

AU - Siersma, Volkert

AU - Gyllenborg, Jesper

AU - Wulffeld, Sandra

AU - Hendriksen, Ole M.

AU - Lippert, Freddy K.

AU - Steinmetz, Jacob

PY - 2017/2/23

Y1 - 2017/2/23

N2 - Background: Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit.Methods:Prospective, observational study with 5.5 years of follow-up. We included patients admitted to the stroke unit the first three years after implementation of a helicopter emergency medical services (HEMS) from a geographical area covered by both the HEMS and the ground emergency medical services (GEMS). HEMS patients were compared with GEMS patients. Primary outcome was long-term mortality after admission to the stroke unit.Results:Of the 1679 patients admitted to the stroke unit, 1068 were eligible for inclusion. Mortality rates were 9.04 per 100 person-years at risk (PYR) in GEMS patients and 9.71 per 100 PYR in HEMS patients (IRR = 1.09, 95% CI 0.79–1.49; p = 0.60). The 30-day mortality was 7.4% with GEMS and 7.9% with HEMS (OR = 1.02, CI 0.53–1.96; p = 0.96). Incidence rate of involuntary early retirement was 6.97 per 100 PYR and 7.58 per 100 PYR in GEMS and HEMS patients, respectively (IRR = 1.19, CI 0.27–5.26; p = 0.81). Work ability after 2 years and time on social transfer payments did not differ between groups. We found no significant difference in mean modified Rankin Scale score after 3 months (2.21 GEMS vs. 2.09 HEMS; adjusted mean difference = −0.20, CI −0.74–0.33; p = 0.46).Discussion:The possible benefit of HEMS for neurological outcome is probably difficult to detect by considering mortality, but for the secondary analyses we had less statistical power as illustrated by the wide confidence intervals.Conclusion:Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved labour market affiliation compared to patients transported by a ground unit.Trial registration:The study was registered at ClinicalTrials.gov (NCT02576379).

AB - Background: Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit.Methods:Prospective, observational study with 5.5 years of follow-up. We included patients admitted to the stroke unit the first three years after implementation of a helicopter emergency medical services (HEMS) from a geographical area covered by both the HEMS and the ground emergency medical services (GEMS). HEMS patients were compared with GEMS patients. Primary outcome was long-term mortality after admission to the stroke unit.Results:Of the 1679 patients admitted to the stroke unit, 1068 were eligible for inclusion. Mortality rates were 9.04 per 100 person-years at risk (PYR) in GEMS patients and 9.71 per 100 PYR in HEMS patients (IRR = 1.09, 95% CI 0.79–1.49; p = 0.60). The 30-day mortality was 7.4% with GEMS and 7.9% with HEMS (OR = 1.02, CI 0.53–1.96; p = 0.96). Incidence rate of involuntary early retirement was 6.97 per 100 PYR and 7.58 per 100 PYR in GEMS and HEMS patients, respectively (IRR = 1.19, CI 0.27–5.26; p = 0.81). Work ability after 2 years and time on social transfer payments did not differ between groups. We found no significant difference in mean modified Rankin Scale score after 3 months (2.21 GEMS vs. 2.09 HEMS; adjusted mean difference = −0.20, CI −0.74–0.33; p = 0.46).Discussion:The possible benefit of HEMS for neurological outcome is probably difficult to detect by considering mortality, but for the secondary analyses we had less statistical power as illustrated by the wide confidence intervals.Conclusion:Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved labour market affiliation compared to patients transported by a ground unit.Trial registration:The study was registered at ClinicalTrials.gov (NCT02576379).

KW - Helicopter emergency medical services

KW - Stroke

KW - Mortality

KW - Labour market affiliation

KW - Disability

U2 - 10.1186/s13049-017-0363-3

DO - 10.1186/s13049-017-0363-3

M3 - Journal article

C2 - 28231814

VL - 25

SP - 1

EP - 9

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

SN - 1757-7241

M1 - 18

ER -

ID: 174471487