Descriptive analysis of cardiac patients transported by critical care air transport teams

Abstract

Introduction: Critical Care Air Transport Teams (CCATTs) transport critically ill patients within and out of theaters of combat operations. Studies of the CCATT population reveal as many as 35% of patients have a non-trauma diagnosis, of which more than half are cardiac. The purpose of this retrospective study was to describe the epidemiology of critically ill patients with cardiac diagnoses evacuated from theater via CCATT. Materials and Methods: We conducted a retrospective review of 290 medical patients with a primary cardiac diagnosis transported from any theater of operation to Landstuhl Regional Medical Center, Germany from January 2007 to April 2015. Results: The majority of patients were male with an average age of 46 ± 11 years, US contractors (47%, n = 137), followed by US Active Duty (32%, n = 93). Patients had an average BMI of 29 ± 5; 62% of cardiac patients were either overweight or obese. The most common cardiac diagnoses were ST elevation myocardial infarction, Non-ST elevation myocardial infarction, and angina. Pre-flight vital signs indicate overall patients were stable prior to evacuation, with the majority receiving supplemental oxygen and only 5% requiring mechanical ventilation. Eighty-one percent of patients experienced at least one cardiac event during flight, however less than 5% required adjustment to oxygen or ventilator settings. Conclusions: Critically ill cardiac patients make up a significant portion of patients transported out of the combat theater. These patients are older, overweight and have identified risk factors for cardiac morbidity. More strenuous pre-deployment screening for risk factors and prevention strategies could minimize the use of military resources to evacuate these patients from the combat theater.