• Tatsuya Ueno, Haruo Nishijima, Hiroki Hikichi, Rie Haga, Akira Arai, Chieko Suzuki, Jin-Ichi Nunomura, Kyoji Saito, and Masahiko Tomiyama.
• Department of Neurology, Aomori Prefectural Central Hospital, Aomori, Japan. Electronic address: tatsuya_ueno@med.pref.aomori.jp.
• J Stroke Cerebrovasc Dis. 2019 Sep 1; 28 (9): 2525-2529.

ObjectivesPhysician-staffed helicopter transport is faster than ground transport and allows for prompt medical care of patients in rural areas. In this study, we evaluated the relationship between helicopter transport and the prognosis of patients with acute cerebral infarction in rural Japan.MethodsThis retrospective, observational study included 546 patients with acute cerebral infarction attending Aomori Prefectural Central Hospital, which serves a rural region of Japan. Patients were separated into 2 transport groups: physician-staffed helicopter emergency medical services and ground emergency medical services. Patients were assessed for stroke severity, treatment, and prognosis.ResultsOf the 546 patients, 11.2% were transported by physician-staffed helicopter emergency medical services and 88.8% by ground emergency medical services. Although the distance transported was significantly longer in the physician-staffed helicopter emergency medical services group, the time from onset to reaching our hospital was similar between the groups. National Institutes of Health Stroke Scale on admission and final prognosis were significantly worse with physician-staffed helicopter emergency medical services than with ground emergency medical services. Multivariate analysis showed no association between transport system and prognosis.ConclusionsIn this study, patients transported by physician-staffed helicopter emergency medical services had more severe stroke symptoms and poorer functional outcomes than those transported by ground emergency medical services. However, the transport time was shorter for physician-staffed helicopter emergency medical services; thus, physician-staffed helicopter emergency medical services may be useful for reducing transport time for patients in rural Japan.Copyright © 2019 Elsevier Inc. All rights reserved.

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