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城市与农村利用波兰直升机紧急医疗服务治疗 ST 段抬高型心肌梗死患者的特征比较。

Characteristics of urban versus rural utilization of the Polish Helicopter Emergency Medical Service in patients with ST-segment elevation myocardial infarction.

机构信息

Department of Emergency Medical Services,Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland; Polish Medical Air Rescue, Warsaw, Poland.

Polish Medical Air Rescue, Warsaw, Poland; Institute of Health Sciences,Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce, Poland

出版信息

Kardiol Pol. 2020 Apr 24;78(4):284-291. doi: 10.33963/KP.15190. Epub 2020 Feb 14.

Abstract

BACKGROUND

In patients with acute phase of ST‑segment elevation myocardial infarction (STEMI), quick transportation to a specialist therapeutic center is of utmost importance to increase the chances of surviving.

AIMS

The objective of this study was to characterize the missions of the Polish Helicopter Emergency Medical Service (HEMS) to patients with STEMI in urban and rural areas and to assess the utilization of air ambulance support as part of an early stage of the therapeutic process.

METHODS

This retrospective analysis included 6099 patients with STEMI treated by the Polish HEMS crews from January 2011 to December 2018.

RESULTS

The study group included mainly men (68.9%) and persons aged 60 to 79 years (53.9%). The mean (SD) age of the entire group was 64.8 (11.9) years. The level of consciousness measured by the Glasgow Coma Scale score ranged from 13 to 15 (84.8% of patients), the mean (SD) Revised Trauma Score was 11.4 (1.9) points, and the mean (SD) number of points on the National Advisory Committee for Aeronautics scale was 4 (1). In rural areas, the Polish HEMS crews were more frequently dispatched to medical emergencies (99.3% vs 59.6%). Sudden cardiac arrest occurred more often in those areas (6% vs 3.8%), which resulted in the death of the patient (2.4% vs 0.4%; P <0.05 for both).

CONCLUSIONS

There were differences in utilization of the Polish HEMS in patients with STEMI in urban and rural areas. The results demonstrated a positive impact of the utilization of HEMS in the early stages of the therapeutic process of these patients.

摘要

背景

在急性 ST 段抬高型心肌梗死(STEMI)患者中,快速转运至专业治疗中心对提高生存机会至关重要。

目的

本研究旨在描述波兰空中医疗急救服务(HEMS)在城市和农村地区对 STEMI 患者的任务,并评估空中救护支持在治疗早期阶段的利用情况。

方法

本回顾性分析纳入了 2011 年 1 月至 2018 年 12 月期间由波兰 HEMS 机组治疗的 6099 例 STEMI 患者。

结果

研究组主要包括男性(68.9%)和 60 至 79 岁的人群(53.9%)。整个组的平均(SD)年龄为 64.8(11.9)岁。格拉斯哥昏迷评分(Glasgow Coma Scale score)测定的意识水平范围为 13 至 15 分(84.8%的患者),修订创伤评分(Revised Trauma Score)的平均(SD)为 11.4(1.9)分,国家航空咨询委员会(National Advisory Committee for Aeronautics)评分的平均(SD)为 4(1)分。在农村地区,波兰 HEMS 机组更频繁地被派往医疗急救(99.3%比 59.6%)。这些地区更常发生心搏骤停(6%比 3.8%),导致患者死亡(2.4%比 0.4%;均<0.05)。

结论

在城市和农村地区 STEMI 患者中,波兰 HEMS 的利用存在差异。结果表明,在这些患者的治疗早期阶段利用 HEMS 具有积极影响。

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