Helicopter transfer offers a potential benefit to patients with acute stroke

Background and Purpose-Rapid transport of patients to specialized centers i s widely used in the management of myocardial infarction, trauma, and more recently, acute stroke. We evaluated the role of helicopter transportation as it relates to the availability of acute stroke therapies and patients' p erceptions of care. Methods-We reviewed records of all patients transferred to a university hos pital within 24 hours of stroke onset from January 1996 to December 1997. D ata were collected on demographics, neurological deficit, treatment, and ou tcome. In addition, a questionnaire was sent to all patients with items abo ut perceived reasons for helicopter transfer, expected and actual treatment , outcome, and overall impression. Results-Helicopter transfer was used for 73 stroke patients. Before transfe r, 8 patients (11%) received tissue plasminogen activator (tPA). On arrival , no patient received tPA, 38 patients (52%) were enrolled in acute stroke studies, and 35 patients (48%) received no specific medication. All but 2 p atients were managed in a specialized stroke unit. Of the 35 patients who r eceived no specific therapy, 24 (69%) were ineligible for treatment or stud y enrollment owing to 1 or more exclusion criteria, but rarely (3%) because of time. Of the 45 respondents to the survey, most (84%) were transferred at the suggestion of the physician at thp originating hospital because of a possible treatment that was unavailable there. Most patients (93%) believe d that there was a benefit from emergent helicopter transfer to a stroke ce nter, although 40% of respondents received no specific therapy. Conclusions-Interhospital transfer by air may benefit a substantial number of acute stroke patients by offering potential therapies and intensive mana gement not available elsewhere.