Aeromedical retrieval diagnostic trends during a period of Coronavirus 2019 lockdown

Fergus W Gardiner; Marianne Gillam; Leonid Churilov; Pritish Sharma; Mardi Steere; Michelle Hannan; Andrew Hooper; Frank Quinlan

doi:10.1111/imj.15091

Aeromedical retrieval diagnostic trends during a period of Coronavirus 2019 lockdown

Intern Med J. 2020 Dec;50(12):1457-1467. doi: 10.1111/imj.15091.

Authors

Fergus W Gardiner^{1

2}, Marianne Gillam³, Leonid Churilov⁴, Pritish Sharma¹, Mardi Steere⁵, Michelle Hannan⁶, Andrew Hooper⁷, Frank Quinlan¹

Affiliations

¹ Federation Office, The Royal Flying Doctor Service, Canberra, Australian Capital Territory, Australia.
² The Rural Clinical School of Western Australia, The University of Western Australia, Perth, Western Australia, Australia.
³ Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia.
⁴ Department of Medicine (Austin Health) and Melbourne Brain Centre at Royal Melbourne Hospital, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
⁵ Central Operations, The Royal Flying Doctor Service, Adelaide, South Australia, Australia.
⁶ Queensland Section, The Royal Flying Doctor Service, Adelaide, South Australia, Australia.
⁷ Western Operations, The Royal Flying Doctor Service, Adelaide, South Australia, Australia.

Abstract

Background: Little is known on the trends of aeromedical retrieval (AR) during social isolation.

Aim: To compare the pre, lockdown, and post-lockdown AR patient characteristics during a period of Coronavirus 2019 (COVID-19) social isolation.

Methods: An observational study with retrospective data collection, consisting of AR between 26 January and 23 June 2020.

Results: There were 16 981 AR consisting of 1983 (11.7%) primary evacuations and 14 998 (88.3%) inter-hospital transfers, with a population median age of 52 years (interquartile range 29.0-69.0), with 49.0% (n = 8283) of the cohort being male and 38.0% (n = 6399) being female. There were six confirmed and 230 suspected cases of COVID-19, with the majority of cases (n = 134; 58.3%) in the social isolation period. As compared to pre-restriction, the odds of retrieval for the restriction and post-restriction period differed across time between the major diagnostic groups. This included, an increase in cardiovascular retrieval for both restriction and post-restriction periods (odds ratio (OR) 1.12, 95% confidence interval (CI) 1.02-1.24 and OR 1.18 95%, CI 1.08-1.30 respectively), increases in neoplasm in the post restriction period (OR 1.31, 95% CI 1.04-1.64) and increases for congenital conditions in the restriction period (OR 2.56, 95% CI 1.39-4.71). Cardiovascular and congenital conditions had increased rates of priority 1 patients in the restriction and post restriction periods. There was a decrease in endocrine and metabolic disease retrievals in the restriction period (OR 0.72, 95% CI 0.53-0.98). There were lower odds during the post-restriction period for retrievals of the respiratory system (OR 0.78, 95% CI 0.67-0.93), and disease of the skin (OR 0.78, 95% CI 0.6-1.0). Distribution between the 2019 and 2020 time periods differed (P < 0.05), with the lockdown period resulting in a significant reduction in activity.

Conclusion: The lockdown period resulted in increased AR rates of circulatory and congenital conditions.

Keywords: aeromedical; coronavirus; pandemic; rural and remote.

Publication types

Observational Study

MeSH terms

Adult
Aged
Air Ambulances*
Australia / epidemiology
COVID-19 / epidemiology*
Communicable Disease Control / methods
Communicable Disease Control / trends*
Female
Humans
Male
Middle Aged
Patient Transfer / trends*
Quarantine / trends*
Retrospective Studies