Association Between Medical Interventions by Doctor Helicopters and Outcomes in Inflammatory Diseases Using a Doctor Helicopter Registry

Abstract

Objective

In Japan, patients with inflammatory diseases are transported from the field by doctor helicopters (DHs). This study aimed to retrospectively investigate the relationship between early medical intervention and outcomes in inflammatory diseases, such as respiratory, urinary tract, and gastrointestinal infections.

Methods

Using data collected by the Japanese Society for Aeromedical Services from DH base hospitals, cases with a discharge diagnosis of inflammatory diseases were selected. The study evaluated age, sex, request method, vital signs on DH staff contact, medical interventions, and final outcomes (cerebral performance category [CPC] at 1 month postinflammation and survival outcome). Exclusion criteria included cases of cardiac arrest at contact and those with unknown final outcomes. The cases were categorized into 2 groups based on survival or functional outcome (favorable: CPC 1-2; unfavorable: CPC 3-5), and a comparative analysis was conducted between the 2 groups.

Results

Of 41,592 cases in the data set, 785 cases met the inclusion criteria. The mean age was 73.8 years, with 491 male patients, 136 deaths, and 272 cases with poor outcomes. All cases were transported from the scene. Compared with the survival group, the fatal group was older and had poorer consciousness, lower blood pressure, higher rates of airway management, and higher use of vasopressors, glucose, and muscle relaxants, whereas the use of antiemetics was statistically lower. Similarly, compared with the favorable functional outcome group, the poor outcome group was older and had a higher proportion of female patients, poorer consciousness, faster respiratory rate and pulse, lower blood pressure, higher rates of airway management, and higher use of cardiopressors, glucose, and muscle relaxants, with a statistically lower use of antiemetics.

Conclusion

In cases where the prehospital condition was severe, medical intervention rates increased, and the outcomes for such patients were poor. Conversely, the presence or absence of antiemetic use may have influenced the outcomes.