Treatment interventions and outcomes of stroke patients transported by helicopter emergency medical services to a comprehensive stroke center.

Authors

M Freymond, K Genise, D O'Dochartaigh, E Violato, J Holodinsky, J P Berard, K Lin

Published in

CJEM. Aug 10, 2026. Epub Aug 10, 2026.

Abstract

Helicopter Emergency Medical Services (EMS) can expedite transport for patients with acute ischemic stroke, yet many cases do not ultimately receive neuro-intervention (i.e., endovascular thrombectomy or neurosurgical procedure). Expanded stroke treatment time windows have increased the number of potential thrombectomy-eligible patients, adding urgency to appropriate resource utilization. The purpose of this study was to describe characteristics and clinical outcomes of patients with known or suspected ischemic stroke transported via helicopter EMS and identify pre-transport factors associated with receiving neuro-intervention.
This four-year population study evaluated adults with confirmed or suspected ischemic stroke transported via helicopter EMS to a comprehensive stroke center in Alberta (Jan 1, 2019 to Dec 31, 2022). The primary outcome was the proportion of patients who received neuro-intervention. Secondary outcomes included neuro-intervention rates comparing early (i.e., < 6 h from 'last seen normal') and late (≥ 6 h) presenters, proportion of 'low-yield' transfers (i.e., died/palliated or discharged/repatriated within 24 h without neuro-intervention), and a comparison of pre- and intra-transport characteristics of patients who received neuro-intervention to those who did not. Exploratory multivariable regression was used to identify pre-transport predictors of neuro-intervention.
Of 226 patients included in this study, 35% (n = 80) received neuro-intervention, with no difference between early (n = 55/154) and late (n = 20/64) presenters (p = 0.64). Conversely, 23% (n = 52) of cases constituted potential 'low-yield' transports. Neuro-intervention rates increased with pre-transport imaging (54% vs. 26%, p < 0.001), pre-transport thrombolysis (33 vs. 13%, p < 0.001) and Los Angeles Motor Scale (LAMS) of 4-5 (92 vs. 63%, p = 0.006). Pre-transport imaging (OR 5.3; 95% CI 1.8-10.7) and thrombolysis (OR 2.8; 95% CI 1.1-12.9) were associated with neuro-intervention.
Approximately one-third of helicopter EMS transports for confirmed or suspected ischemic stroke resulted in neuro-intervention. Pre-transport imaging and thrombolysis were strongly associated with neuro-intervention, underscoring the important role of primary stroke centers in optimizing patient care and resource utilization.

PMID:
42573948
Bibliographic data and abstract were imported from PubMed on 10 Aug 2026.

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