Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, The Netherlands.
BMC Emerg Med. 2024 Sep 27;24(1):173. doi: 10.1186/s12873-024-01088-6.
Trauma patients treated by the Helicopter Emergency Medical Services (HEMS) can be transported to the hospital either by helicopter or by ambulance, in both cases accompanied by the HEMS physician. The objectives of this study are first to compile an overview of patients treated and transported by the HEMS team with either the helicopter (patients transported by helicopter, PTH) or with the ambulance (patients transported by ambulance, PTA). In addition, to evaluate whether the existing information systems obtain relevant data for researching the decision-making process. The second objective is to identify potentially influencing factors that could be significant for further research.
All patients in the period from 1 January 2011 until 31 December 2020, treated by HEMS and subsequently transported to hospitals were included in the study. To avoid overrepresentation of the PTA group, a random sample was taken, creating two groups in a 1:2 ratio (PTH n = 724, PTA n = 1448). Differences in patient and treatment characteristics between PTH and PTA were compared using t-tests, Mann-Whitney U tests, and chi-square tests.
PTH accounted for 12.2% of all transports. Approximately two-third of the patients were male and the mean age was around 40 years. PTH had lower iEMV (initial Eye opening, best Motor response, best Verbal response) and iRTS (initial Revised Trauma Score) scores, were more frequently transported to a level 1 trauma centre, underwent more prehospital treatments and were roughly twice as far from their hospital of arrival compared to PTA.
The current dataset is, after some modifications, suitable to provide a comprehensive overview of patients treated by HEMS in the Netherlands. A predictive model could be developed using this dataset, which should include factors such as the patient's location, age, distance to the hospital, physician on duty, mechanism of injury and overall injury severity.
接受直升机紧急医疗服务（HEMS）治疗的创伤患者可通过直升机或救护车被送往医院，在这两种情况下，都有 HEMS 医生陪同。本研究的目的首先是对通过直升机（经直升机转运的患者，PTH）或救护车（经救护车转运的患者，PTA）转运的 HEMS 团队治疗和转运的患者进行概述。此外，评估现有的信息系统是否获取了研究决策过程的相关数据。第二个目的是确定可能对进一步研究有重要意义的潜在影响因素。
研究纳入了 2011 年 1 月 1 日至 2020 年 12 月 31 日期间，接受 HEMS 治疗并随后被送往医院的所有患者。为了避免 PTA 组的代表性过高，采用了随机抽样，创建了 1:2 的两组（PTH n=724，PTA n=1448）。使用 t 检验、Mann-Whitney U 检验和卡方检验比较 PTH 和 PTA 两组患者和治疗特征的差异。
PTH 占所有转运的 12.2%。约三分之二的患者为男性，平均年龄约为 40 岁。PTH 的 iEMV（初始睁眼、最佳运动反应、最佳言语反应）和 iRTS（初始修订创伤评分）得分较低，更频繁地被转运至 1 级创伤中心，接受更多的院前治疗，且与 PTA 相比，距离到达医院的距离大约是其两倍。
对原始数据集进行一些修改后，本研究适合提供荷兰 HEMS 治疗患者的全面概述。可以使用该数据集开发预测模型，该模型应包括患者位置、年龄、距离医院的距离、值班医生、损伤机制和整体损伤严重程度等因素。
