離島で発症し急性期にヘリコプター搬送を受けたくも膜下出血患者の転帰

Abstract

To determine the risk and benefit of emergency helicopter transport of island patients for treatment of subarachnoid hemorrhage (SAH), we retrospectively analyzed 96 consecutive patients with SAH treated in our institution over the last 2 years. The island group consisted of 55 island patients who received emergency helicopter transport, the mean distance and duration of which were 140 km and 40 minutes, respectively. The land group consisted of 41 land patients transported by ambulance. Only one rerupture during flight was confirmed among the island group. Age, sex, and the time interval between onset and admission did not significantly differ between the 2 groups. At admission, there were 3 patients with Hunt & Kosnik (H & K) Grade 5 in the island group, and 7 with H & K Grade 5 in the land group, and the poor-grade patients were fewer in the former (p=0.09). Fifty-two of 55 patients in the island group, and 29 of 41 patients in the land group were treated operatively or interventionally, and 2 of the former and 12 of the latter were conservatively treated mainly because of poor grade, which was significantly different (p=0.003). At discharge, the number of patients with modified Rankin Scale Grade 0, 1, and 2 were 27 in the island group, and 12 in the land group, and the outcome of patients in the former tended to be better (p=0.09). The emergency helicopter medical transport of the patients with SAH was thought to be safe and effective.