Air versus ground transport for patients with st-elevation myocardial infarction: does transport type affect patient outcomes?

J Emerg Nurs. 2013 Sep;39(5):e65-74. doi: 10.1016/j.jen.2012.03.011. Epub 2012 Jul 12.

Abstract

Introduction: This study was conducted to examine whether air versus ground transport from non-percutaneous coronary intervention (PCI) centers to PCI centers affects the health and quality of life of persons with ST-elevation myocardial infarction (STEMI) 30 days after cardiac interventional treatment.

Methods: Data for the analysis were collected between January 2006 and December 2008 for 195 patients with STEMI who received no thrombolytic therapy but were transported by air or ground from non-PCI centers to PCI centers for cardiac intervention.

Results: Although the observed differences were not statistically significant because of the sample size, the study showed that at 30 days after discharge a larger percentage of ground transport patients had experienced an infarction (17.5% vs 10.7%), stroke (4.2% vs 2.7%), or died (5.8% vs 2.7%) compared with air transport patients. The analyses should be considered relative to the clinical and operational importance of the results, particularly with regard to postdischarge status.

Discussion: Because "time is muscle" with patients who have a STEMI, it is crucial to perform studies that provide solid statistical data showing that the type of transport affects patient outcome. This knowledge could lead to the implementation of a regional transport protocol between non-PCI and PCI centers to provide a more streamlined plan of care, thus affecting patients' long-term quality of life.

Keywords: Air-medical; Ground transport; Patient outcomes; STEMI.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Air Ambulances / statistics & numerical data
  • Ambulances / statistics & numerical data*
  • Analysis of Variance
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery*
  • Outcome and Process Assessment, Health Care / methods*
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Percutaneous Coronary Intervention / methods
  • Quality of Life
  • Recurrence
  • Stroke / complications
  • Time Factors