Mortality rates in Norwegian HEMS – a retrospective analysis from Central Norway

Abstract

Abstract Background: Helicopter Emergency Medical Services (HEMS) provide rapid and specialized care to critically ill or injured patients. Norwegian HEMS in Central Norway serves an important role in pre-hospital emergency medical care. To grade the severity of patients, HEMS uses the National Advisory Committee on Aeronautics’ (NACA) severity score. The objective of this study was to analyze mortality rates and corresponding NACA values in patients transported by Trondheim HEMS. Methods: The study uses a retrospective cohort design, aligning with the STROBE recommendations. Patient data from Trondheim HEMS between 01.01.2017 and 31.12.2019 was analyzed. Kaplan Meier plots and cumulative mortality rates were calculated for each NACA group at day one, day 30, and one year and three years after the incident. Results: Trondheim HEMS responded to 2224 alarms in the included time period, with 1431 patients meeting inclusion criteria for the study. Overall mortality rates at respective time points were 10.1% at day one, 13.4% at 30 days, 18.5% at one year, and 22.3% at three years. The one-year cumulative mortality rates for each NACA group were as follows: 0% for NACA 1 and 2, 2.9% for NACA 3, 10.1% for NACA 4, 24.7% for NACA 5 and 49.5% for NACA 6. Statistical analysis with a global log-rank test indicated a significant difference in survival outcomes among the groups (p < 2×10-16). Conclusion: The research identifies elevated short- and long-term mortality among patients transported by Trondheim HEMS, and clearly show an incremental rise in mortality rates with increasing NACA scores. Findings align with previous studies but reveal variations, potentially influenced by interpretation differences, regional disparities, and advancements in medical technology. The study further suggests that a one-year follow-up may be sufficient for future investigations into HEMS outcomes. This paper provides valuable reference points for physicians using the NACA score, and further validates the NACA score as a severity scoring system.