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Aeromedical Retrieval for Stroke in Australia.

Fergus William Gardiner1,2, Lara Bishop3,4, Angela Dos Santos5,6,7

  • 1The Royal Flying Doctor Service, Federation Office, Barton, Australian Capital Territory, Australia, fergus.gardiner@rfds.org.au.

Cerebrovascular Diseases (Basel, Switzerland)
|June 25, 2020
PubMed
Summary

Aeromedical retrievals for stroke in Australia are lengthy, exceeding timeframes for reperfusion therapies. Indigenous patients, often younger, face similar delays, highlighting the need for faster stroke diagnosis and treatment in rural areas.

Keywords:
AccessibilityAeromedicalEquityIndigenousRuralStroke

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Area of Science:

  • Medical Retrieval and Transport
  • Stroke Neurology
  • Indigenous Health Outcomes

Background:

  • Rural, remote, and Indigenous populations in Australia experience poorer stroke outcomes compared to urban counterparts.
  • This disparity is potentially linked to limited access to specialized stroke facilities and timely interventions.

Purpose of the Study:

  • To characterize patients undergoing aeromedical retrieval for stroke.
  • To estimate the time taken for aeromedical stroke transfers.
  • To assess the alignment of flight paths with Australian stroke unit locations.

Main Methods:

  • A prospective review of Royal Flying Doctor Service (RFDS) data from July 2014 to June 2018.
  • Inclusion of patients with ICD-10 codes I60-I69 undergoing RFDS aeromedical retrieval.
  • Utilized 2017 National Stroke Audit data to identify stroke unit locations and imaging capabilities.

Main Results:

  • 1,773 stroke aeromedical retrievals were conducted, with 16.5% involving Indigenous patients.
  • Indigenous patients were significantly younger (56.0 years) than non-Indigenous patients (66.0 years).
  • Median retrieval time was 238 minutes, often exceeding critical reperfusion windows; most patients were transferred to facilities with stroke units and imaging.

Conclusions:

  • Aeromedical retrieval times for stroke patients in Australia frequently exceed therapeutic windows for reperfusion.
  • Younger Indigenous populations are disproportionately affected by aeromedical stroke retrievals.
  • Future research must focus on improving the speed of diagnosis and treatment for stroke patients in remote settings.