3 research outputs found
Survival benefit of physician-staffed Helicopter Emergency Medical Services (HEMS) assistance for severely injured patients
Background: Physician-staffed Helicopter Emergency Medical Services (HEMS) provide specialist
medical care to the accident scene and aim to improve survival of severely injured patients. Previous
studies were often underpowered and showed heterogeneous results, leaving the subject at debate. The
aim of this retrospective, adequately powered, observational study was to determine the effect of
physician-staffed HEMS assistance on survival of severely injured patients.
Methods: All consecutive severely injured trauma patients (ISS >15) between October 1, 2000 and
February 28, 2013 were included. Assistance of physician-staffed HEMS was compared with assistance
from the ambulance paramedic crew (i.e., EMS group) only. A regression model was constructed for
calculating the expected survival and survival benefit.
Results: A total of 3543 polytraumatised patients with an ISS >15 were treated at the Emergency
Department, of whom 2176 patients remained for analysis; 1495 (69%) were treated by EMS only and
681 (31%) patients received additional pre-hospital care of HEMS. The model with the best fit and
diagnostic properties (H–L coefficient 2.959, p = 0.937; AUC 0.888; PPV 71.4%; NPV 88.0%) calculated that
36 additional patients survived because of HEMS assistance. This resulted in an average of 5.33 additional
lives saved per 100 HEMS dispatches for severely injured patients.
Conclusion
Timing of pulmonary valve replacement in patients with corrected Fallot to prevent QRS prolongation
OBJECTIVES: Timing of pulmonary valve replacement (PVR) remains one of the most heavily debated topics in congenital cardiac surgery. We aimed to analyse the temporal evolution of QRS duration before and after PVR. METHODS: We included 158 consecutive patients who underwent PVR after previous correction with transannular patch. All 3549 available serial standard 12-lead surface QRS measurements of 158 (100%) patients were analysed with linear mixed-effect modelling. RESULTS: PVR was perfo