Helicopter Emergency Medical Services save lives: outcome in a cohort of 1073 polytraumatized patients
| Autor: | Christa Boer, Fred C. Bakker, Elly S.M. de Lange-de Klerk, Herman M. T. Christiaans, Frank W. Bloemers, Mischka N. Kolodzinskyi, G. F. Giannakópoulos, Wietse P. Zuidema |
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| Přispěvatelé: | Surgery, Anesthesiology, Epidemiology and Data Science, ICaR - Circulation and metabolism |
| Rok vydání: | 2013 |
| Předmět: |
Male
inorganic chemicals Emergency Medical Services medicine.medical_specialty macromolecular substances Statistics Nonparametric Time-to-Treatment Cohort Studies Patient safety Injury Severity Score Trauma Centers Confidence Intervals polycyclic compounds Emergency medical services First Aid Humans Medicine Glasgow Coma Scale heterocyclic compounds Survivors Netherlands Retrospective Studies Chi-Square Distribution integumentary system Multiple Trauma business.industry Retrospective cohort study Air Ambulances medicine.disease Survival Analysis Triage Treatment Outcome Cohort Emergency medicine Emergency Medicine Female Patient Safety Medical emergency business Cohort study |
| Zdroj: | Giannakopoulos, G F, Kolodzinskyi, M N, Christiaans, H M T, Boer, C, de Lange-de Klerk, E S M, Zuidema, W P, Bloemers, F W & Bakker, F C 2013, ' Helicopter Emergency Medical Services save lives: outcome in a cohort of 1073 polytraumatized patients ', European Journal of Emergency Medicine, vol. 20, no. 2, pp. 79-85 . https://doi.org/10.1097/MEJ.0b013e328352ac9b European Journal of Emergency Medicine, 20(2), 79-85. Lippincott Williams and Wilkins |
| ISSN: | 0969-9546 |
| DOI: | 10.1097/mej.0b013e328352ac9b |
| Popis: | In many Western countries, Helicopter Emergency Medical Services (HEMS) have become standard in the prehospital care of severely injured patients. Several studies have shown that HEMS have a positive effect on patient's outcome, although it remains unclear which specific patients benefit most from its care. The aim of this study was to assess the effect of HEMS on the outcome of a large polytraumatized (Injury Severity Score≥16) population.All polytraumatized patients treated at the scene of the accident by EMS and/or HEMS and presented in the VU University Medical Center during a period of 6 years were included and retrospectively analyzed. The total population was divided into two groups according to the presence of HEMS on-scene. Prehospital, in-hospital, and outcome parameters were compared. The Trauma Injury Severity Score method was used to calculate the probability of survival.Almost 60% of all included patients (n=1073) were treated only by an EMS crew on-scene. The remaining 446 patients received additional HEMS care. Significant differences between these two groups were observed in the demographic characteristics, showing that the HEMS group was more severely injured. The predicted survival was calculated using the Trauma Injury Severity Score method, as well as the observed survival, both showing a significantly higher outcome for the EMS group (0.88 vs. 0.66% and 87.7 vs. 71.3%). However, the Z-statistic showed a significant positive difference between the predicted and the observed survival for the HEMS group (P0.005) and no significant differences for the EMS group (P0.1), indicating that the chance of surviving in the HEMS group was higher. Per 100 HEMS dispatches, 5.4 additional lives were saved. A correlation of the observed survival with the first measured Revised Trauma Score on-scene showed a positive effect for the HEMS group when the Revised Trauma Score reached a value of 9 or lower.On-scene HEMS care has a positive effect on the survival of polytraumatized patients, saving 5.4 additional lives per 100 HEMS deployments. This positive effect is especially observed in patients with abnormal vital signs (respiratory and hemodynamically). Research and revision of dispatch criteria are important to reach patients that benefit most from HEMS care. |
| Databáze: | OpenAIRE |
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