The Norwegian Air Ambulance Service is a nationwide system served by helicopter and fixed wing aircraft bases.5 The Royal Norwegian Air Force's anaesthesiologist-manned 330 Squadron is a dedicated search and rescue (SAR) helicopter service and also contributes regularly to the national Air Ambulance system. We reviewed all missions completed by the SAR base at Banak, Northern Norway, during the period 1 January 1999 to 31 December 2009. We included all patients that had been treated by the service and assessed using the NACA score. Pre-hospital data (patient ID, date of mission, diagnosis, NACA score, pre-hospital interventions and the institution to which the patient was admitted) were collected from the service's electronic patient record.
The hospitals in Hammerfest, Kirkenes and Tromsø receive patients from the service. Relevant in-hospital data from the hospital records of the patients were recorded. Ventilatory support was defined as the institution or continuation of any form of positive pressure ventilation either via endotracheal intubation or non-invasive ventilatory support during the first 24 h after admission. Haemostatic emergency surgery was assessed at two levels of definitions: (1) defined as haemostatic packing of the abdomen or pelvis, or thoracotomy exceeding tube thoracostomy, and (2) the earlier definition plus tube thoracostomy and/or emergency orthopaedic procedures performed within 24 h.
Thirty-day mortality was assessed using the hospitals' medical records based on The National Population Register. Norwegian patients from the catchment area of the hospitals discharged before 30 days after admission have their medical records updated with survival data from The National Population Register, while persons living outside the region were lost to follow-up with regards to mortality. Patients without information on 30-day mortality were considered as survivors if they were discharged to their home directly, even if a follow-up consultation was planned.
Data collection was performed by two experienced consultant anaesthesiologists, with more than 4 years of experience in pre-hospital emergency medicine. The relationship between the NACA score and the outcome measures was assessed using receiver operating characteristic (ROC) curves. With this test, the true positive rate (sensitivity) is plotted against the false-positive rate (1 – specificity) to receive a graphic estimate of the test or scoring system performance as the area under the curve (AUC).6 (link)–9 (link) We regarded an AUC of more than 0.8 as a good and an AUC of more than 0.95 as excellent predictor of outcome.
The hospitals in Hammerfest, Kirkenes and Tromsø receive patients from the service. Relevant in-hospital data from the hospital records of the patients were recorded. Ventilatory support was defined as the institution or continuation of any form of positive pressure ventilation either via endotracheal intubation or non-invasive ventilatory support during the first 24 h after admission. Haemostatic emergency surgery was assessed at two levels of definitions: (1) defined as haemostatic packing of the abdomen or pelvis, or thoracotomy exceeding tube thoracostomy, and (2) the earlier definition plus tube thoracostomy and/or emergency orthopaedic procedures performed within 24 h.
Thirty-day mortality was assessed using the hospitals' medical records based on The National Population Register. Norwegian patients from the catchment area of the hospitals discharged before 30 days after admission have their medical records updated with survival data from The National Population Register, while persons living outside the region were lost to follow-up with regards to mortality. Patients without information on 30-day mortality were considered as survivors if they were discharged to their home directly, even if a follow-up consultation was planned.
Data collection was performed by two experienced consultant anaesthesiologists, with more than 4 years of experience in pre-hospital emergency medicine. The relationship between the NACA score and the outcome measures was assessed using receiver operating characteristic (ROC) curves. With this test, the true positive rate (sensitivity) is plotted against the false-positive rate (1 – specificity) to receive a graphic estimate of the test or scoring system performance as the area under the curve (AUC).6 (link)–9 (link) We regarded an AUC of more than 0.8 as a good and an AUC of more than 0.95 as excellent predictor of outcome.
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