Assessment of Aeromedical Evacuation Transport Patient Outcomes With and Without Cabin Altitude Restriction
Technical Report,01 Mar 2014,31 Aug 2017
USAF School of Aerospace Medicine Wright-Patterson AFB United States
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This study investigated whether there was a difference in inflight status, clinical outcomes, and mission costs between aeromedically evacuated AE patients transported with and without a cabin altitude restriction CAR. The theater validating flight surgeon TVFS prescribes the CAR. Although general guidelines have been published regarding CAR, they are not evidence-based. A retrospective matched case-control study was conducted. From 1207 CAR patients from 2007-2013 found in the U.S. Transportation Command Regulating and Command and Control Evacuation System database, 50 CAR patients with relatively complete data capture were randomly selected. These patients were matched with 50 non-CAR patients using International Classification of Diseases, Ninth Revision codes and, to some extent, aircraft. Demographics, preflight characteristics, inflight physiological characteristics, and postflight outcomes, as well as mission cost parameters, were assembled for analysis. Overall, these patients were young, Army, and, for the most part, suffering orthopedic trauma caused by improvised explosive devices. In addition, most were flown on C-17s under Priority precedence. All were Critical Care Air Transport Team accompanied with Injury Severity Scores exceeding 25. Excepting few differences, the CAR and non-CAR groups were very similar, suggesting that any difference in clinical or operational outcomes might well be related to the CAR prescription. There was no difference in length of stay, intensive care unit days, postflight transfusions, or discharge status. However, a statistically significant difference in the number of postflight procedures was observed there were, on average, five postflight procedures per patient in the CAR group versus six in the non-CAR group.
- Escape, Rescue and Survival