Savell Shelia C, Arana Allyson A, Medellin Kimberly L, Bebarta Vikhyat S, Perez Crystal A, Reeves Lauren K, Mora Alejandra G, Maddry Joseph K
US Air Force En Route Care Research Center 59 MDW/ST, Chief Scientist's Office - US Army Institute of Surgical research, JBSA Ft. Sam Houston, TX.
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
Mil Med. 2019 Jul 1;184(7-8):e288-e295. doi: 10.1093/milmed/usy426.
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.
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.
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.
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.
重症护理空中运输团队（CCATTs）负责在作战区域内外运送重症患者。对CCATT运送患者群体的研究表明，多达35%的患者患有非创伤性疾病诊断，其中一半以上是心脏疾病。这项回顾性研究的目的是描述通过CCATT从战区撤离的患有心脏疾病诊断的重症患者的流行病学情况。
我们对2007年1月至2015年4月期间从任何作战区域转运至德国兰施图尔地区医疗中心的290例原发性心脏疾病诊断的内科患者进行了回顾性研究。
大多数患者为男性，平均年龄46±11岁，美国承包商（47%，n = 137），其次是美国现役军人（32%，n = 93）。患者的平均体重指数为29±5；62%的心脏病患者超重或肥胖。最常见的心脏诊断为ST段抬高型心肌梗死、非ST段抬高型心肌梗死和心绞痛。飞行前生命体征表明，总体患者在撤离前情况稳定，大多数患者接受补充氧气，只有5%需要机械通气。81%的患者在飞行期间至少经历了一次心脏事件，然而不到5%的患者需要调整氧气或呼吸机设置。
重症心脏病患者占从战区转运出的患者的很大一部分。这些患者年龄较大、超重，且已确定存在心脏发病的危险因素。更严格的部署前危险因素筛查和预防策略可将从战区撤离这些患者所使用的军事资源降至最低。
