Clinical Significance of Helicopter Transportation for Patients With Acute Illness Admitted to Medical Intensive Care Unit.

Background: We aimed to elucidate the characteristics and prognosis of patients admitted to a medical intensive care unit (ICU) by helicopter emergency medical service (HEMS). Methods and Results: Among 11,140 patients transported via the institute's HEMS from January 2012 to December 2021, 459 were admitted to the medical ICU and included as the HEMS group. The 3,810 patients who were transported by other means to the medical ICU comprised the non-HEMS group. Multivariable logistic regression analysis revealed that cardiovascular etiologies other than acute heart failure (AHF), as well as younger age and the requirement of mechanical support (endotracheal intubation and intra-aortic balloon pumping), were associated with HEMS transport. Kaplan-Meier curve analysis revealed that 365-day survival was significantly better in the HEMS group than in the non-HEMS group. A multivariable Cox regression model identified HEMS transport as an independent predictor of a favorable 365-day all-cause survival (hazard ratio: 1.326, 95% confidence interval: 1.024-1.718, P=0.033) relative to other means of transport. Conclusions: Cardiovascular diseases other than AHF were the main reasons for helicopter transportation to the medical ICU. The HEMS group were younger and more likely to require circulatory/respiratory assist devices than the non-HEMS group. The HEMS was significantly associated with better 365-day survival; therefore, appropriate transportation means need to be selected to improve the prognosis of non-surgical patients.