Evidence map›Paper›PMID 40753408›Full record

Observational studyBMC emergency medicine2025

Major medical events in patients with acute coronary syndrome during helicopter emergency medical service operations.

Julian Ganter, Hans-Jörg Busch, Alina Henis, Florian Reifferscheid, Jörg Braun, Sebastian Heinrich

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Julian GanterDepartment of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. Julian.ganter@uniklinik-freiburg.de.
Hans-Jörg BuschGerman Air Rescue Service Association DRF Luftrettung, Rita-Maiburg-Str. 2, 70794, Filderstadt, Germany.
Alina HenisDepartment of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Florian ReifferscheidGerman Air Rescue Service Association DRF Luftrettung, Rita-Maiburg-Str. 2, 70794, Filderstadt, Germany.
Jörg BraunGerman Air Rescue Service Association DRF Luftrettung, Rita-Maiburg-Str. 2, 70794, Filderstadt, Germany.
Sebastian HeinrichDepartment of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute coronary syndromes (ACS) are a leading cause of helicopter emergency medical services (HEMS) operations in Germany. Complications that arise during HEMS operations are challenging due to limited resources. However, the National Advisory Committee for Aeronautics (NACA) score and National Early Warning Score (NEWS) provide potential for risk stratification. Nevertheless, there is an absence of data concerning the incidence and risk of medical events (e.g. malignant arrhythmia, cardiac arrest, cardiogenic shock) in ACS patients during HEMS operations. The objective of this study is to evaluate the incidence of medical events and to assess risk stratification using scoring systems.

methodsThis retrospective observational cohort study analyzed prehospital records from 38,473 HEMS operations with "ACS" coding conducted between 2012 and 2024 in Germany. Routine data were systematically recorded using a standardized digital form that captured patient demographics, clinical presentation, and medical interventions. Major medical events (MME) were defined using surrogate markers, including defibrillation, resuscitation, airway management, ventilation, and new ST-elevation myocardial infarction (STEMI) findings. Scores (NACA, NEWS, and a combined MME-score) were calculated, with the MME-score integrating NACA and NEWS. Ethical approval was obtained from the Albert-Ludwigs-University Freiburg Ethics Committee (No: 24-1082-S1, 25 April 2024).

resultsMME occurred in 8.8% of the 38,473 HEMS operations. They occurred more frequently during secondary missions (interfacility transports) (11.8%) than primary missions (6.7%), and at night (15.3%) than during the day (8.2%) (both p < 0.001). The NACA, NEWS, and MME-scores were significantly higher in cases with medical events (p < 0.001). The risk stratification exhibited areas under the curve in the receiver operating characteristics (ROC) curve, with values of 0.831 for NACA, 0.866 for NEWS, and 0.895 for the MME-score.

conclusionThe incidence of MMEs is subject to variation depending on the operational context. Established scoring systems such as the NACA and NEWS are available for the purpose of risk stratification of medical events in patients with ACS during air rescue operations. The combination of these scores may indicate potential for improved risk stratification.

Indexed as

Acute Coronary SyndromeAir AmbulancesEmergency Medical ServicesAdultAgedAged, 80 and overFemaleGermanyHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk AssessmentAir rescue serviceCardiac arrestDefibrillationEmergency medicineRisk stratification

Identifiers

PMID40753408
PMCPMC12318427

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.