Characteristics of urban vs rural utilization of helicopter emergency medical service in patients with ST-elevation myocardial infarction in Poland

BACKGROUND: To increase the chances of surviving the acute phase of ST-elevation myocardial infarction (STEMI) it is necessary to quickly transport the patient to a specialist therapeutic centre. AIMS: The objective of this study was to characterise the missions of Helicopter Emergency Medical Service (HEMS) to patients with STEMI in urban and rural areas and to assess the utilization of air ambulance support as a part of an early stage of the therapeutic process. METHODS: The study was conducted using the retrospective analysis of HEMS missions in Poland. The study included 6099 cases of STEMI treated by HEMS crews from January 2011 to December 2018. RESULTS: The study group consisted mainly of men (68.9%) and persons aged 60-79 (53.9%), the mean age of the entire analysed group was 64.8 (SD 11.9). The level of consciousness of patients was in the range between 13-15 (84.8%), the mean RTS score was 11.4 points (SD 1.9) and the mean number of points on the NACA scale was 4.0 (SD 1.0). In rural areas HEMS crews were more frequently dispatched to medical emergencies (99.3% vs 59.6%), sudden cardiac arrest occurred more often (6.0% vs 3.8%), which resulted in the death of the patient (2.4% vs 0.4%) (p<0.05). CONCLUSIONS: There are significant differences in utilisation of HEMS on patients with STEMI in urban and rural areas. The results of the study show the positive impact of the utilization of HEMS as a part of the early stage of the therapeutic process of patients with STEMI.