title: Nonurgent commercial air travel after acute coronary syndrome: a review of 288 patient events.
abstract: OBJECTIVE
  We studied a population of individuals who experienced an acute coronary syndrome (ACS) event while traveling abroad and required nonurgent commercial air travel to the home region.
  
  
  METHODS
  This retrospective study gathered data from 288 patients enrolled in a travel-based medical assistance program. Interventions, complications, and travel home were assessed for trends. Descriptive and comparison statistical analyses were performed.
  
  
  RESULTS
  Two hundred eighty-eight patients were identified and entered into the review. Of the patients in this study, 77.1% were male with an average age of 67.7 years. One hundred sixteen (40.3%) patients were diagnosed with unstable angina pectoris (USAP), whereas the remaining 172 (59.7%) patients experienced acute myocardial infarction (AMI). Regarding inpatient complications during the initial admission, 121 (42.0%) patients experienced 1 or more adverse event. The average number of days after an ACS event that a patient began to travel home was 10.5 days for the entire patient population (USAP patients = 8.8 days, AMI patients = 11.8 days). Two hundred twenty (76.4%) patients traveled with a medical escort, and 48 (16.7%) patients received supplemental oxygen during air travel. Four (1.4%) in-flight adverse events occurred in the following ACS diagnostic groups: 2 in the complicated AMI group, 1 in the uncomplicated USAP group, and 1 in the uncomplicated AMI group. No in-flight deaths occurred. Nine (3.1%) deaths were noted within 2 weeks after returning to the home region. The deaths after returning to the home region occurred in the following ACS diagnostic groups: 2 in the complicated USAP group, 1 in the uncomplicated USAP group, and 6 in the complicated AMI group. None of the patients who experienced in-flight events died after returning to their home region.
  
  
  CONCLUSIONS
  Upon discharge, the vast majority of ACS patients who travel to their home region via commercial air do not experience adverse events in-flight; when such adverse events occur in-flight, these events do not result in a poor outcome. No in-flight deaths occurred; death occurred in a minority of patients after returning to their home region, particularly in the complicated USAP and AMI groups, who were planned readmissions to the hospital.
authors.affiliation: Grand Canyon National Park, Branch of Emergency Services.
authors.forename: Emily
authors.initials: E
authors.lastname: Pearce
authors.affiliation: Allianz Global Assistance-Canada, Kitchener, Ontario, Canada.
authors.forename: Faith
authors.initials: F
authors.lastname: Haffner
authors.affiliation: Curry School of Education, University of Virginia, Charlottesville, VA.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Brady
authors.affiliation: Allianz Global Assistance-Canada, Kitchener, Ontario, Canada; Department of Emergency Medicine, University of Virginia, Charlottesville, VA; Allianz Global Assistance-United States, Richmond, VA.
authors.forename: Mark
authors.initials: M
authors.lastname: Sochor
authors.affiliation: Allianz Global Assistance-France, Paris, France.
authors.forename: Francois X
authors.initials: FX
authors.lastname: Duchateau
authors.affiliation: Allianz Global Assistance-Canada, Kitchener, Ontario, Canada; Department of Emergency Medicine, University of Virginia, Charlottesville, VA; Allianz Global Assistance-United States, Richmond, VA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: O'Connor
authors.affiliation: Allianz Global Assistance-France, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Verner
authors.affiliation: Allianz Global Assistance-Canada, Kitchener, Ontario, Canada; Department of Emergency Medicine, University of Virginia, Charlottesville, VA; Allianz Global Assistance-United States, Richmond, VA. Electronic address: wb4z@virginia.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Brady
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D000368:Aged; D000401:Aircraft; D000789:Angina, Unstable / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014195:Travel / Q000706:statistics & numerical data; D057236:Travel Medicine