Clinical Outcomes of Patients Experiencing Seizures Treated With Antiemetic Drugs During Transport by Physician-Staffed Helicopters in Japan

Objective

We conducted a retrospective study to evaluate the clinical significance of antiemetic drug use in patients with seizures who were transported by physician-staffed helicopters (Doctor Helicopters [DHs]) in Japan.

Methods

Data retrieved included patient age, sex, presence or absence of cardiac arrest on DH staff contact, vital signs at the time of contact, details of medical interventions, duration of hospitalization, and final outcome. Patients who experienced cardiac arrest at the time of DH contact and those with missing final outcome data were excluded. Given the established prognostic significance of age and level of consciousness in patients with seizures, individuals younger than 46 years and those with a Glasgow Coma Scale score of <9 were excluded to minimize baseline variability between the 2 groups, based on the results of a preliminary analysis. Subjects were divided into the following 2 groups: the Control group (no antiemetic administered prehospital) and the Antiemetic group.

Results

The Control group included 532 patients, whereas the Antiemetic group comprised 149 patients. No significant differences were observed between the 2 groups in terms of sex, age, respiratory rate, systolic blood pressure, Glasgow Coma Scale score, mortality rate, or hospitalization rate. However, the Antiemetic group demonstrated a significantly lower rate of endotracheal intubation and a significantly better cerebral performance category score compared with the Control group.

Conclusion

This is the first study to evaluate the prognostic role of antiemetic use in older adults with seizures during helicopter transport in Japan. Future prospective, randomized, double-blind studies are warranted to determine whether the use of antiemetic agents serves as a prognostic factor in patients with seizures.