Air Med J. 2025 Nov-Dec;44(6):478-484. doi: 10.1016/j.amj.2025.06.023. Epub 2025 Jul 23.
ABSTRACT
OBJECTIVE: Air medical evacuation (AE) plays a vital role in emergency medical services by facilitating swift transfer of critically ill or injured patients to advance health care facilities. Despite its increasing importance, standardized protocols and comprehensive research on AE outcomes remain scarce, particularly in Nepal. This study evaluates clinical characteristics, interventions, and prognostic determinants of AE cases managed by anesthesiologists at a military tertiary care hospital.
METHODS: This retrospective observational study analyzed AE cases handled by anesthesiologists in an 11-year period (July 2013-July 2024). Data were retrieved from hospital records, encompassing patient demographics, clinical characteristics, air medical factors, and outcomes. The primary outcomes assessed were in-hospital mortality and recovery. Chi-square tests and logistic regression analyses were used to evaluate associations between key clinical variables and patient outcomes.
RESULTS: The study included 83 patients, with a median age of 30 years (interquartile range: 23-36) and a male-to-female ratio of 16:1. Road traffic accidents were leading cause of AE (39.8%), followed by high-altitude illness and heat-related conditions (9.6% each). Mortality was significantly associated with hemodynamic instability (odds ratio: 96.67, 95% confidence interval: 11.34-823.77, P < .001) and intubation status (odds ratio: 12.75, 95% confidence interval: 3.236-50.191, P < .001), whereas no significant correlation was observed between the reason for AE and mortality.
CONCLUSIONS: Our study represents first in-depth analysis of AEs involving anesthesiologists in Nepal, identifying illness severity, hemodynamic instability, and intubation status as significant predictors of mortality. The findings underscore urgent need for improved AE infrastructure, implementation of standardized protocols, and specialized training to enhance patient outcomes.
PMID:41161876 | DOI:10.1016/j.amj.2025.06.023
