Mortality and hospitalisation in the Danish Helicopter Emergency Medical Service (HEMS) population from 2014 to 2018: a national population-based study of HEMS triage

Abstract

ObjectiveTo 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.DesignNational population-based study.Setting and participantsHEMS 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 1st October 2014 and 30th April 2018.Main outcome measuresMortality rates, admittance to an intensive care unit (ICU), need of mechanical ventilation and length of hospital stay (LOS).Results6931 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.ConclusionPatients 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.

Emergency Air Transport of Patients with Acute Chest Pain in the Adriatic Islands of Croatia: A Four-Year Analysis

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“…In 2 recent studies describing patient characteristics and mortality for different HEMS mission types, 3,4 similar findings were reported when analyzing the entire HEMS patient population. 4 Christensen et al 21 described mortality and diagnostic distribution among a cohort of emergency patients brought to the hospital by ambulance during the period 2007 to 2014 in the North Denmark region. The study showed mortality at day 1 and day 30 of 1.8% and 4.7%, respectively.…”

Characteristics and Demographics of Patients Requiring Emergent Air Medical

“…Di Rocco et al looked at a population with a mean age of 51, and 61% were male [ 7 ]. Alstrup et al report two separate studies where the population had a median age of 60 and males composed 71% in one study and 64% in the second study [ 8 , 9 ]. The pediatric patient population had a median age of two in this study, with 60% male participants.…”

“…This study examines a general view of patients transported by helicopter, while other studies, such as by Di Rocco et al, have limited patient demographics. Di Rocco et al gathered information on flight distances and flight interventions, which this study did not [ 8 ]. This study only looked at the time to call for transport at the sending facility and the patient's length of stay at the sending facility before transport arrives.…”