Mortality and hospitalisation in the Danish Helicopter Emergency Medical Service (HEMS) population from 2014 to 2018: a national population-based study of HEMS triage.
| Autor: | Alstrup K; Department of Research and Development, Pre-hospital Emergency Medical Service, Aarhus N, Denmark karals@rm.dk., Petersen JAK; Department of Anaesthesiology, Aarhus University Hospital, Aarhus N, Denmark.; The Danish Air Ambulance, Aarhus, Denmark., Sollid S; R&D, Norwegian Air Ambulance Foundation, Drobak, Norway.; Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway., Johnsen SP; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, University of Aalborg, Aalborg, Denmark., Rognås L; Department of Anaesthesiology, Aarhus University Hospital, Aarhus N, Denmark.; The Danish Air Ambulance, Aarhus, Denmark. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ open [BMJ Open] 2020 Aug 30; Vol. 10 (8), pp. e038718. Date of Electronic Publication: 2020 Aug 30. |
| DOI: | 10.1136/bmjopen-2020-038718 |
| Abstrakt: | Objective: To describe characteristics and outcomes for patients where the Danish Helicopter Emergency Medical Service (HEMS) either transported the patient to hospital, treated the patient on scene but did not transport the patient or was dispatched but cancelled en route to the patient (aborted mission), and to assess the field triage by comparing these outcomes. Design: National population-based study. Setting and Participants: HEMS dispatches are undertaken from the five Danish emergency dispatch medical centres according to national guidelines. The study analysed all primary missions with helicopter take off where the patient was admitted to hospital between 1 st October 2014 and 30 th April 2018. Main Outcome Measures: Mortality rates, admittance to an intensive care unit (ICU), need of mechanical ventilation and length of hospital stay (LOS). Results: 6931 patients were admitted to hospital; 3311 patients were air lifted, 164 patients were ground escorted by a HEMS physician, 1421 were assisted on scene by HEMS, but escorted by the ground units and 2035 missions were aborted. The mortality was highest among the airlifted and ground escorted patients, and lowest among the patients in the aborted mission group. Mortality for the airlifted patients increased from 8.2% (95% CI; 7.3 to 9.2) at day 1 to 19.5% (95% CI; 18.2 to 20.9) after 1 year. The airlifted and ground escorted patients were frequently admitted to ICU and subsequently mechanically ventilated and they also had an increased LOS compared with the patients only assisted on scene by HEMS and the patients in the aborted mission group. Conclusion: Patients to whom HEMS are dispatched are often critically ill or injured and have a relatively high mortality. The patients airlifted or ground escorted to hospital by HEMS appear more critically ill or injured compared with the assisted patients and the patients in the aborted mission group. The on-scene triage seems appropriate. Competing Interests: Competing interests: KA have received funding from the Danish HEMS research foundation. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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