Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot97110.32687/0869-866X-2022-30-4-656-665Научная статьяThe routing of medical evacuation of patients with ruptures of cerebral aneurysms from remote out-of-the-way rural areaVorobyovE. A.ea7788@yahoo.comDashyanV. G.-SavvinaN. V.-ChugunovaS. A.-YakhontovI. S.-MakievskyjM. Yu.-The State Budget Educational Institution of Higher Professional Education “The A. E. Evdokimov Moscow State University of Medicine and Dentistry” of Minzdrav of RussiaThe State Budget Institution of the Republic of Sakha (Yakutia) “The Republican Hospital № 2 - The Center of Emergency Medical Care”The Federal State Autonomous Educational Institution of Higher Education “The M. K. Ammosov Northern-East Federal University”1512202230465666517082022Copyright © 2022,2022The patients with aneurysm subarachnoid hemorrhage (aSAH) living in remote, inaccessible, rural areas cannot be provided with urgent neurosurgical care on the spot. They require medical evacuation (ME) to neurosurgical hospital. The purpose of the study was to investigate effect of complex (multi-stage) and simple (one-stage) logistic scheme of ME of patients in acute period of aSAH on the outcome of the disease. The retrospective analysis of results of surgical treatment in 145 patients with aSAH hospitalized in regional vascular center (RVC) in Yakutsk in 2017-2018 was carried out. The subjects were allocated into 3 groups: group 1 - patients from regions of the Republic of Sakha, who underwent ME to the RSC using simple transportation scheme; group 2 - patients from regions of the Republic of Sakha who underwent ME using complex transportation scheme; group 3 (control) - patients hospitalized from territory of Yakutsk.The RVC hospitalized 145 patients. The sanitary aviation delivered 91 (62.8%) patients from districts of the Republic to the RVC. The duration of time from the onset of disease to surgical treatment: in group 1-2 days; in group 2-4 days; in group 3, 2 days (p = 0.018). The frequency of re-rupture of cerebral aneurysm in the group 1 and group 2 did had no statistically significant differences (19,1% and 32.7%) (p = 0.142). Mortality: in group 1 7.1%; in group 2 8.2%; in group 3 7.4% and no statistically significant differences between groups 1 and 2 (p = 1,000), between groups 1 and 3 (p = 1,000) and between groups 2 and 3 (p = 0.886). 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