Helicopter transport of patients to tertiary care centers after cardiac arrest

Air transport is commonly used to transfer survivors of cardiac arrest from rural hospitals to large tertiary-care centers, presumably to improve outc ome. To examine this issue, a retrospective review of patients stabilized a fter a cardiac arrest was conducted; 157 transports were reviewed, The mean age of patients was 37.9 +/- 27.8 yrs, with a male to female ratio of 2.2: 1, survivors were significantly older than nonsurvivors, Thirty one of 69 p atients (45%) with primary cardiac disease were discharged alive from the h ospital, 75% without neurological sequelae, Only a minority of patients wit h noncardiac medical illness (7%), electrical injury (33%), suffocation (15 %) near-drowning (15%), end inhalation (0%) were discharged alive from the hospital, Outcomes for cardiac arrest in adult patients older than 65 years (32.3%% survival) were similar to those for adult patients younger than 65 years (36.2% survival) (P = .887), These results show that survivors of a primary cardiac event have a favorable outcome when transferred by air to t ertiary centers when compared with historical controls that were transporte d by ground. On the other hand, cardiac arrests from noncardiac medical ill ness, suffocation, near-drowning, and inhalation have a grim prognosis. Pro spective studies should clarify the role of air transport in these patients , Copyright (C) 1999 by W.B. Saunders Company.