Urologic In-Flight Medical Events on Commercial Airlines.

Abstract

PURPOSE\nIn-flight medical events are rare but may cause significant distress as access to care is limited. There is a paucity of data on in-flight urologic medical events. We sought to describe urologic in-flight medical emergencies (IME) and report clinical and flight outcomes.\n\n\nMATERIALS AND METHODS\nWe reviewed all in-flight urologic medical emergencies between 2015 and 2017 from MedAire, a ground-based medical support center that provides remote medical advisory services to approximately 35% of commercial airline passenger traffic worldwide. Our primary endpoint was the incidence rates of in-flight urologic medical events. We also characterized the types of IMEs, in-flight management and their impact on flight status. Statistical analyses included students t-tests, chi-square analysis and analysis of variance.\n\n\nRESULTS\nWe identified 1,368 (1.0%) urologic IMEs from a total of 138,612 IMEs, with an incidence of 0.50 per million passengers. The most common IMEs were lower urinary tract symptoms (35%), urinary retention (30%) and flank pain (21%). Among the IMEs, 883 (60%) resolved in-flight, 273 (28%) required on-arrival medical evaluation, and 21 (1.5%) resulted in flight diversions. Of flight diversions, the majority were due to urinary retention (n=12, 57%), and less commonly by flank pain (n=6, 28%) and testicular/abdominal pain (n=3, 15%).\n\n\nCONCLUSIONS\nThe most common causes of urologic IME are lower urinary tract symptoms, urinary retention and renal colic - the majority of which resolved in-flight. These data are useful for informing flight personnel and equipment needs contained in emergency kits to minimize the impact of these events when they occur.