Decision criteria of immediate aeromedical evacuation.
BACKGROUND
The decision whether to immediately evacuate an international traveler who has become ill is a challenge for physicians of aeromedical evacuation companies. The aim of this study is to characterize international aeromedical evacuations in order to identify predictive factors that indicate urgent evacuation.


METHODS
The records from all consecutive aeromedical evacuations and overseas repatriations carried out by Mondial Assistance France between August 2006 and July 2007 were reviewed for this study. Patients were allocated to one of two groups: those requiring immediate aeromedical evacuation by air-ambulance and those whose condition allowed subsequent, nonurgent repatriation. Data were compared between the two groups.


RESULTS
Overseas repatriations numbering 402 were executed: 35 immediate aeromedical evacuations with air-ambulance and 367 nonurgent repatriations. Age < or =15 years [odds ratio (OR), 7.0; 95% CI, 1.6-30.6], whether there was a high standard structure in the country (OR, 0.28; 95% CI, 0.09-0.85), and location in sub-Saharan Africa (OR, 12.6; 95% CI, 2.3-71.4) were independent factors indicating the need for immediate aeromedical evacuation.


CONCLUSIONS
Patient age, availability of local resources, and locations are the criteria associated with the need for immediate aeromedical evacuation. Creation of a specific standardized scoring system based on these criteria could be of great value to help physicians of aeromedical evacuation companies in initial management of cases.
Duchateau
François-Xavier
FX
Mondial Assistance France, Medical Department, Paris, France. francois-xavier.duchateau@mondial-assistance.fr
Verner
Laurent
L
Cha
Olivier
O
Corder
Bob
B
D000328:Adult; D000368:Aged; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D003657:Decision Making; D005602:France; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D008875:Middle Aged; D012307:Risk Factors; D014187:Transportation of Patients / Q000379:methods; D014195:Travel; D055815:Young Adult