Longitudinal Assessment of a Single Referring-Receiving Hospital Pair to Assess Air Versus Ground Elapsed Time From Transport Request to Arrival at Cardiac Catheterization Laboratory: An Observational Cohort Study

Abstract

Objective

Timely reperfusion is crucial for improving outcomes in patients with ST-elevation myocardial infarction (STEMI). The impact of transport mode on time to treatment for patients with STEMI over short distances (<10 miles) is not well studied. This study aimed to compare the time from transport request to percutaneous coronary intervention (PCI) suite arrival between helicopter emergency medical services (HEMS) and ground emergency medical services (GEMS) for patients with STEMI.

Methods

We conducted a retrospective cohort study involving 22 patients with STEMI transported by either HEMS or GEMS from a single referring hospital to a single receiving hospital PCI suite, located 8 miles apart, from January 2020 to January 2023. Data on transport times were collected from hospital records and Google Maps estimates. We analyzed the time intervals using descriptive and inferential statistics, including mean comparisons and regression analyses.

Results

Air transport (HEMS) was significantly faster than ground transport (GEMS) by a mean of 32 minutes (95% confidence interval: 21.1-42.9 minutes). This difference was clinically significant in 50% of the cases. Sensitivity analyses using longer HEMS transport times confirmed the robustness of the findings. No significant changes in transport times were observed over the study period.

Conclusion

HEMS may offer time advantages compared with GEMS for short-distance transfers in STEMI cases, though the small sample size limits the robustness of these findings. Further research with larger samples and additional outcome measures is needed to confirm these results and assess the broader implications for emergency medical transport.