Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea: results from over 100 rescue missions

Mikkel Malby Schoos; Henning Kelbæk; Frants Pedersen; Benedict Kjærgaard; Sven Trautner; Lene Holmvang; Erik Jørgensen; Steffen Helqvist; Kari Saunamäki; Thomas Engstrøm; Peter Clemmensen

doi:10.1136/emermed-2013-202771

Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea: results from over 100 rescue missions

Mikkel Malby Schoos, Henning Kelbæk, Frants Pedersen, Benedict Kjærgaard, Sven Trautner, Lene Holmvang, Erik Jørgensen, Steffen Helqvist, Kari Saunamäki, Thomas Engstrøm, Peter Clemmensen

Department of Clinical Medicine

7 Citations (Scopus)

Abstract

BACKGROUND: Since 2005, ST-elevation myocardial infarction (STEMI) patients from the island of Bornholm in the Baltic Sea have been transferred for primary percutaneous coronary intervention (pPCI) by an airborne service. We describe the result of pPCI as part of the Danish national reperfusion strategy offered to a remote island population.

METHODS: In this observational study, patients from Bornholm (n=101) were compared with patients from the mainland (Zealand) (n=2495), who were grouped according to time intervals (<120, 121-180, >180 min). The primary endpoint was all-cause 30-day mortality. Individual-level data from the Central Population Registry provided outcome that was linked to our inhospital PCI database.

RESULTS: Treatment delay was longer in patients from Bornholm (349 min (IQR 267-446)) vs Zealand (211 (IQR 150-315)) (p<0.001). In patients from Zealand, 30-day mortality did not increase with time intervals (p=0.176), whereas, long-term mortality did (∼3 years) (p=0.007). Thirty-day mortality was similar for Bornholm and the overall Zealand group (5.9% vs 6.2% p=0.955). Early presenters (<180 min) from Zealand (37%) had similar 30-day (5.3% vs 5.9% p=0.789), but numerically reduced long-term mortality compared with Bornholm (12.8% vs 15.8% p=0.387). Age, female gender, diabetes, Killipclass >2 and preprocedural thrombolysis in myocardial infarction (TIMI) flow 0/1 independently predicted 30-day mortality, however, treatment delay did not. Postprocedural TIMI flow 3 predicted improved survival.

CONCLUSIONS: In this small population of STEMI patients from a remote island, airborne transfer appears feasible and safe, and their 30-day mortality after pPCI comparable with that of the mainland population despite inherent reperfusion delay exceeding guidelines.

Original language	English
Journal	Emergency Medicine Journal
Volume	31
Issue number	11
Pages (from-to)	920-5
Number of pages	6
ISSN	1472-0205
DOIs	https://doi.org/10.1136/emermed-2013-202771
Publication status	Published - 1 Nov 2014

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10.1136/emermed-2013-202771

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Schoos, M. M., Kelbæk, H., Pedersen, F., Kjærgaard, B., Trautner, S., Holmvang, L., Jørgensen, E., Helqvist, S., Saunamäki, K., Engstrøm, T., & Clemmensen, P. (2014). Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea: results from over 100 rescue missions. Emergency Medicine Journal, 31(11), 920-5. https://doi.org/10.1136/emermed-2013-202771

Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea : results from over 100 rescue missions. / Schoos, Mikkel Malby; Kelbæk, Henning; Pedersen, Frants et al.

In: Emergency Medicine Journal, Vol. 31, No. 11, 01.11.2014, p. 920-5.

Research output: Contribution to journal › Journal article › Research › peer-review

Schoos, MM, Kelbæk, H, Pedersen, F, Kjærgaard, B, Trautner, S, Holmvang, L, Jørgensen, E, Helqvist, S, Saunamäki, K, Engstrøm, T & Clemmensen, P 2014, 'Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea: results from over 100 rescue missions', Emergency Medicine Journal, vol. 31, no. 11, pp. 920-5. https://doi.org/10.1136/emermed-2013-202771

@article{d88a362f2f514277865a0e9f51496b6f,

title = "Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea: results from over 100 rescue missions",

abstract = "BACKGROUND: Since 2005, ST-elevation myocardial infarction (STEMI) patients from the island of Bornholm in the Baltic Sea have been transferred for primary percutaneous coronary intervention (pPCI) by an airborne service. We describe the result of pPCI as part of the Danish national reperfusion strategy offered to a remote island population.METHODS: In this observational study, patients from Bornholm (n=101) were compared with patients from the mainland (Zealand) (n=2495), who were grouped according to time intervals (<120, 121-180, >180 min). The primary endpoint was all-cause 30-day mortality. Individual-level data from the Central Population Registry provided outcome that was linked to our inhospital PCI database.RESULTS: Treatment delay was longer in patients from Bornholm (349 min (IQR 267-446)) vs Zealand (211 (IQR 150-315)) (p<0.001). In patients from Zealand, 30-day mortality did not increase with time intervals (p=0.176), whereas, long-term mortality did (∼3 years) (p=0.007). Thirty-day mortality was similar for Bornholm and the overall Zealand group (5.9% vs 6.2% p=0.955). Early presenters (<180 min) from Zealand (37%) had similar 30-day (5.3% vs 5.9% p=0.789), but numerically reduced long-term mortality compared with Bornholm (12.8% vs 15.8% p=0.387). Age, female gender, diabetes, Killipclass >2 and preprocedural thrombolysis in myocardial infarction (TIMI) flow 0/1 independently predicted 30-day mortality, however, treatment delay did not. Postprocedural TIMI flow 3 predicted improved survival.CONCLUSIONS: In this small population of STEMI patients from a remote island, airborne transfer appears feasible and safe, and their 30-day mortality after pPCI comparable with that of the mainland population despite inherent reperfusion delay exceeding guidelines.",

author = "Schoos, {Mikkel Malby} and Henning Kelb{\ae}k and Frants Pedersen and Benedict Kj{\ae}rgaard and Sven Trautner and Lene Holmvang and Erik J{\o}rgensen and Steffen Helqvist and Kari Saunam{\"a}ki and Thomas Engstr{\o}m and Peter Clemmensen",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",

year = "2014",

month = nov,

day = "1",

doi = "10.1136/emermed-2013-202771",

language = "English",

volume = "31",

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journal = "Emergency Medicine Journal",

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TY - JOUR

T1 - Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea

T2 - results from over 100 rescue missions

AU - Schoos, Mikkel Malby

AU - Kelbæk, Henning

AU - Pedersen, Frants

AU - Kjærgaard, Benedict

AU - Trautner, Sven

AU - Holmvang, Lene

AU - Jørgensen, Erik

AU - Helqvist, Steffen

AU - Saunamäki, Kari

AU - Engstrøm, Thomas

AU - Clemmensen, Peter

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - BACKGROUND: Since 2005, ST-elevation myocardial infarction (STEMI) patients from the island of Bornholm in the Baltic Sea have been transferred for primary percutaneous coronary intervention (pPCI) by an airborne service. We describe the result of pPCI as part of the Danish national reperfusion strategy offered to a remote island population.METHODS: In this observational study, patients from Bornholm (n=101) were compared with patients from the mainland (Zealand) (n=2495), who were grouped according to time intervals (<120, 121-180, >180 min). The primary endpoint was all-cause 30-day mortality. Individual-level data from the Central Population Registry provided outcome that was linked to our inhospital PCI database.RESULTS: Treatment delay was longer in patients from Bornholm (349 min (IQR 267-446)) vs Zealand (211 (IQR 150-315)) (p<0.001). In patients from Zealand, 30-day mortality did not increase with time intervals (p=0.176), whereas, long-term mortality did (∼3 years) (p=0.007). Thirty-day mortality was similar for Bornholm and the overall Zealand group (5.9% vs 6.2% p=0.955). Early presenters (<180 min) from Zealand (37%) had similar 30-day (5.3% vs 5.9% p=0.789), but numerically reduced long-term mortality compared with Bornholm (12.8% vs 15.8% p=0.387). Age, female gender, diabetes, Killipclass >2 and preprocedural thrombolysis in myocardial infarction (TIMI) flow 0/1 independently predicted 30-day mortality, however, treatment delay did not. Postprocedural TIMI flow 3 predicted improved survival.CONCLUSIONS: In this small population of STEMI patients from a remote island, airborne transfer appears feasible and safe, and their 30-day mortality after pPCI comparable with that of the mainland population despite inherent reperfusion delay exceeding guidelines.

AB - BACKGROUND: Since 2005, ST-elevation myocardial infarction (STEMI) patients from the island of Bornholm in the Baltic Sea have been transferred for primary percutaneous coronary intervention (pPCI) by an airborne service. We describe the result of pPCI as part of the Danish national reperfusion strategy offered to a remote island population.METHODS: In this observational study, patients from Bornholm (n=101) were compared with patients from the mainland (Zealand) (n=2495), who were grouped according to time intervals (<120, 121-180, >180 min). The primary endpoint was all-cause 30-day mortality. Individual-level data from the Central Population Registry provided outcome that was linked to our inhospital PCI database.RESULTS: Treatment delay was longer in patients from Bornholm (349 min (IQR 267-446)) vs Zealand (211 (IQR 150-315)) (p<0.001). In patients from Zealand, 30-day mortality did not increase with time intervals (p=0.176), whereas, long-term mortality did (∼3 years) (p=0.007). Thirty-day mortality was similar for Bornholm and the overall Zealand group (5.9% vs 6.2% p=0.955). Early presenters (<180 min) from Zealand (37%) had similar 30-day (5.3% vs 5.9% p=0.789), but numerically reduced long-term mortality compared with Bornholm (12.8% vs 15.8% p=0.387). Age, female gender, diabetes, Killipclass >2 and preprocedural thrombolysis in myocardial infarction (TIMI) flow 0/1 independently predicted 30-day mortality, however, treatment delay did not. Postprocedural TIMI flow 3 predicted improved survival.CONCLUSIONS: In this small population of STEMI patients from a remote island, airborne transfer appears feasible and safe, and their 30-day mortality after pPCI comparable with that of the mainland population despite inherent reperfusion delay exceeding guidelines.

U2 - 10.1136/emermed-2013-202771

DO - 10.1136/emermed-2013-202771

M3 - Journal article

C2 - 23878063

SN - 1472-0205

VL - 31

SP - 920

EP - 925

JO - Emergency Medicine Journal

JF - Emergency Medicine Journal

IS - 11

ER -

Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea: results from over 100 rescue missions

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