Obesity Status Is a Predictor of Prolonged Interfacility Transport by Air Ambulance: A Population-Based Retrospective Cohort Study

Objective: Delays in access to emergency care are potentially detrimental to patient health. Evidence suggests that patients with obesity may be more prone to delays in health care settings. Methods: The primary objective of this study is to determine whether obesity status is an independent predictor of prolonged interfacility transport by air ambulance to access definitive care in Ontario, Canada. This was a population-based retrospective cohort study of all emergent interfacility transfers of patients, at least 16 years of age, performed by Ontario’s sole air ambulance provider, a total of 15,466 patients, from January 2017 to December 2020. Six different time intervals were identified during the patients’ transfers from the site of emergency to a sending facility and, then, to a receiving facility. Obesity status was defined by the ambulance provider as weight ≥120 kg, and covariables included patient-, paramedic-, and institution-level characteristics. The primary outcome was the change in total modifiable time of transfer, defined as the sum of the 6 time intervals. Multivariable regression analyses explored the relationship between obesity status and total modifiable time after risk adjustment. Results: Of the 15,466 patients transferred, 739 (4.8%) were classified with obesity status. The median total modifiable time was 137 minutes. Obesity status was associated with increase of 41 minutes in total modifiable time (95% confidence interval, 14-67 minutes; P < .01). Use of a rotor aircraft was associated with a reduction in total modifiable time of 154 minutes (95% confidence interval, 131-177 minutes; P < .01). Conclusion: Obesity status was associated with an increase in modifiable duration of emergent air ambulance interfacility transfers in Ontario.

Duke Scholars

Author James Jung Surgery, Minimally Invasive Surgery