Counts, Characteristics and Outcomes of Patients Transported by the Royal Flying Doctor Service to Metropolitan Perth With Suspected Acute Coronary Syndrome: Western Australian Linked Data Study.
The Australian journal of rural health · 2025-09-23 · Observational study
Abstract
OBJECTIVES: Determine counts, characteristics and outcomes following transport by the Royal Flying Doctor Service Western Operations (RFDSWO) to Perth. STUDY DESIGN: Retrospective cohort study of the RFDSWO aeromedical patient dataset linked to administrative datasets. PARTICIPANTS: Suspected acute coronary syndrome (ACS) patients aged ≥ 25 years transported from rural Western Australia to Perth between 2001 and 2017. MAIN OUTCOME MEASURES: Basic counts and proportions. Poisson regression was used to determine absolute change in number of transports and relative risk (RR) of receiving diagnostic coronary angiography; logistic regression to model odds ratio (OR) of death between transport and end of hospital care. RESULTS: RFDSWO carried out 11 390 transports for suspected ACS between 2001 and 2017, with the absolute number of annual transports increasing by 6.0%. After excluding 164 transports without linked records, the remaining 11 226 consisted of patients with a mean age of 60.3 years and 70.8% male. Most (99.1%) were hospitalised and 1.8% died. Among those hospitalised, 84.5% received diagnostic coronary angiography and 74.5% were discharged with a diagnosis of ACS. Females (RR = 0.97; CI = 0.95-0.99), higher comorbidity scores, and those from the Pilbara/Midwest/Wheatbelt regions (compared to South West) were less likely to receive diagnostic coronary angiography. Older patients (OR = 1.07; CI = 1.06-1.11), earlier transport years, higher comorbidity scores, those with priority 1 transport or requiring medical escort, and those from the Kimberley (compared to South West) were more likely to die. CONCLUSIONS: Findings suggest a high suspicion of coronary artery pathology among transported patients. Patient-level and regional differences in outcomes warrant further investigation with more granular data.