Aeromedical transport after acute myocardial infarction

TY - JOUR

T1 - Aeromedical transport after acute myocardial infarction

AU - Seidelin, Jakob B

AU - Bruun, Niels Eske

AU - Nielsen, Henrik

N1 - Keywords: Adult; Aged; Aged, 80 and over; Air Ambulances; Algorithms; Coronary Angiography; Decision Support Techniques; Decision Trees; Denmark; Electrocardiography; Exercise Test; Female; Humans; Male; Middle Aged; Myocardial Infarction; Risk Assessment; Severity of Illness Index; Statistics, Nonparametric

PY - 2009

Y1 - 2009

N2 - BACKGROUND: No guidelines exist for the planning of aeromedical repatriation after acute myocardial infarction (AMI). In 2004, we employed a risk evaluation-based decision-making system for repatriation of patients after AMI. The objective was to evaluate the safety of transports during 2005 managed by this system. METHODS: A total of 116 patients were transported according to the algorithm, 64 unescorted and 52 escorted. The decision-making system was based on the recommendations given by the European Society of Cardiology. Whenever possible, patients were evaluated by coronary angiogram or exercise electrocardiogram. Patients at high risk were treated locally if appropriate facilities were available or evacuated to the nearest heart center. Patients at low risk were allowed to fly unescorted home if no other concomitant diseases needed the attention of a physician. The composite end point of death of any cause during transport or departure from the planned repatriation due to worsening of the condition was registered. RESULTS: No patients reached the end point. Patients who were not risk evaluated more often needed escort (p < 0.04). Escorted patients were older (p < 0.001) and had more post-AMI complications (p < 0.04). CONCLUSIONS: Patients can safely travel unescorted after AMI if their risk of ischemia is low as determined by risk stratification examination prior to repatriation.

AB - BACKGROUND: No guidelines exist for the planning of aeromedical repatriation after acute myocardial infarction (AMI). In 2004, we employed a risk evaluation-based decision-making system for repatriation of patients after AMI. The objective was to evaluate the safety of transports during 2005 managed by this system. METHODS: A total of 116 patients were transported according to the algorithm, 64 unescorted and 52 escorted. The decision-making system was based on the recommendations given by the European Society of Cardiology. Whenever possible, patients were evaluated by coronary angiogram or exercise electrocardiogram. Patients at high risk were treated locally if appropriate facilities were available or evacuated to the nearest heart center. Patients at low risk were allowed to fly unescorted home if no other concomitant diseases needed the attention of a physician. The composite end point of death of any cause during transport or departure from the planned repatriation due to worsening of the condition was registered. RESULTS: No patients reached the end point. Patients who were not risk evaluated more often needed escort (p < 0.04). Escorted patients were older (p < 0.001) and had more post-AMI complications (p < 0.04). CONCLUSIONS: Patients can safely travel unescorted after AMI if their risk of ischemia is low as determined by risk stratification examination prior to repatriation.

U2 - 10.1111/j.1708-8305.2008.00281.x

DO - 10.1111/j.1708-8305.2008.00281.x

M3 - Journal article

C2 - 19335808

SN - 1195-1982

VL - 16

SP - 96

EP - 100

JO - Journal of Travel Medicine

JF - Journal of Travel Medicine

IS - 2

ER -