Percutaneous coronary intervention, repatriation and unplanned readmissions: Characteristics of percutaneous coronary intervention patients who experience an unplanned readmission after repatriation from a tertiary hospital

BACKGROUND The use of air ambulances to transport cardiac patients has grown rapidly over the past decade in New Zealand. There were in excess of 3000 fixed wing air ambulance missions flown in 2005. Both pressurized and unpressurized air ambulances are used. The altitude exposure guidelines for safe transport of people with heart disease were developed 50 years ago. These guidelines do not meet best practice standards and there is little research into transportation of acutely unwell or post interventional cardiac patients in the aeromedical environment. In the New Zealand context there are no consistent guidelines between the various aeromedical services for the transportation of cardiac patients in air ambulances. OBJECTIVE The objective was to describe the demographic and clinical characteristics of patients who have an unplanned readmission to a regional hospital after undergoing percutaneous coronary angioplasty at a tertiary hospital. METHODOLOGY AND DESIGN A cohort study design of patients repatriated using different transport types was undertaken using observational data from admission episode information, and international classification of diseases codes. The data were extracted from the National Minimum Dataset and from a regional hospital’s patient transport database. Sixteen thousand eight hundred and fifty patient records were included in the study comprising of 18,577 index admissions. Five hundred and fifty-six patients were in the cohort of readmissions after repatriation to the regional hospital. FINDINGS Patients who were transported by commercial aircraft have a significantly lower incidence of unplanned readmission than patients who were transported by air ambulance. However, there is no statistical difference in unplanned readmission rates when comparing the use of unpressurized air ambulance to pressurized air ambulance transportation. Patients who undergo percutaneous coronary intervention are at significantly lower risk of unplanned readmission than those who undergo coronary artery bypass graft surgery, or coronary angiography. CONCLUSION Unplanned readmission to hospital of patients after undergoing percutaneous coronary intervention is not influenced by the type of air ambulance used in their repatriation. The current altitude guidelines for transportation of cardiac patients appear to be safe to use in air ambulance transports of post percutaneous coronary intervention patients who have a flight time less than 90 minutes. Unplanned readmission to hospital of post percutaneous coronary intervention patients may be influenced by the close and extended monitoring of them during repatriation via air ambulance.

Name thesis:degree_name

Master of Nursing

Level thesis:degree_level

Masters

Grantor

Eastern Institute of Technology

Year dc:date.issued

2009

Author dc:creator

• Kennedy, Peter

• Hawke's Bay (N.Z.)
• New Zealand
• cardiac patients
• percutaneous coronary intervention (PCI)
• patient repatriation
• aeromedical transportation
• air ambulances
• patient readmissions
• Māori
• flight nurses

Statement dc:rights

• All rights reserved

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/10652/6594

OAI identifier oai:identifier

oai:null:10652/6594