Evaluation of the Repatriation Process for Major Trauma Patients: Our Experience at Addenbrooke's Hospital, Cambridge...

Major trauma patients succumb to significant injuries that require transfer to a major trauma center (MTC) for appropriate management. After the acute phase of treatment is over, the challenge arises when these patients require repatriation back to their local National Health Service hospitals for further rehabilitation. According to the "Major Trauma Clinical Network Specification," one of the metrics is for patients to be repatriated to their local trauma unit within 48 hours of getting an accepting consultant. This study aims to evaluate the efficiency and feasibility of repatriating the patients within that timeframe.

This was a retrospective study where we reviewed patients admitted to our Trauma and Orthopedics Department between January 2022 and June 2024. Medical records of patients were extracted through the hospital's IT system. Patients who were not local to our MTC and required repatriation were included in the study.

A total of 224 patients were included in the study. Among them, 154 patients were repatriated to their local trauma unit. Only 31 patients (~14%) got repatriated within 48 hours of getting an accepting consultant. Seventy patients (31%) were discharged to their usual place of residence as they became medically and therapeutically fit for discharge before having an available bed. On average, four bed days per patient were lost during the repatriation process.

Repatriation is a resource-intensive process integral to major trauma care delivery. It helps patients in terms of functional recovery and psychological wellness, as they are closer to family and friends.