K Simon1, P-Y Cordier2, V Pommier de Santi3, A Luft4, C Brossier5, E Peytel2, F Simon6. 1. Pôle bloc-anesthésie-réanimation-urgences, service d'accueil des urgences, hôpital d'instruction des armées LAVERAN, BP 60149, 13384 Marseille cedex 13, France. Electronic address: kimkrissimon@hotmail.fr. 2. Pôle bloc-anesthésie-réanimation-urgences, service d'accueil des urgences, hôpital d'instruction des armées LAVERAN, BP 60149, 13384 Marseille cedex 13, France. 3. Centre d'épidémiologie et de santé publique des armées, GSBdD Marseille Aubagne - CESPA, BP 40029, 13568 Marseille cedex 02, France; SSA, VITROME, IHU-Méditerranée infection, Aix Marseille université, IRD, AP-HM, Marseille, France. 4. Pôle OBS 2B/123, État-major opérationnel santé M7, 60, boulevard du Général Martial-Valin, CS 21623, 75509 Paris cedex 15, France. 5. Centre d'épidémiologie et de santé publique des armées, GSBdD Marseille Aubagne - CESPA, BP 40029, 13568 Marseille cedex 02, France. 6. Pôle formation enseignement recherche, hôpital d'instruction des armées LAVERAN, BP 60149, 13384 Marseille cedex 13, France.
Abstract
OBJECTIVES: Medical evacuations from foreign settings are a major health and strategic problem for the armed forces. This work aimed to study the characteristics of French military evacuations due to infectious diseases. PATIENTS AND METHODS: We performed a retrospective study based on the registers of the French operational military staff for health to assess the characteristics of the strategic medical evacuation of French armed forces members on missions abroad between January 1, 2011 and December 31, 2016. RESULTS: Out of 4633 included cases, 301 medical evacuations (6.5%) were carried out due to infectious situations. More than half of patients were repatriated to surgical wards (162 patients, 54%), 108 patients (36%) to medical wards, 21 patients (7%) to intensive care units, six patients (2%) to an armed forces medical center, and four files (1%) were incomplete. Among infectious emergencies, malaria led to 30 evacuations (10%) including 11 to intensive care units and one death before evacuation. Infectious diseases requiring medical evacuation were most often mild and community-acquired. Most soldiers were evacuated without medical assistance. CONCLUSIONS: Infectious diseases during missions and medical repatriations carried out for infectious reasons are important epidemiological indicators to monitor. They make it possible to adapt preventive measures, training, and diagnostic and therapeutic tools which can be made available to front-line military physicians.
OBJECTIVES: Medical evacuations from foreign settings are a major health and strategic problem for the armed forces. This work aimed to study the characteristics of French military evacuations due to infectious diseases. PATIENTS AND METHODS: We performed a retrospective study based on the registers of the French operational military staff for health to assess the characteristics of the strategic medical evacuation of French armed forces members on missions abroad between January 1, 2011 and December 31, 2016. RESULTS: Out of 4633 included cases, 301 medical evacuations (6.5%) were carried out due to infectious situations. More than half of patients were repatriated to surgical wards (162 patients, 54%), 108 patients (36%) to medical wards, 21 patients (7%) to intensive care units, six patients (2%) to an armed forces medical center, and four files (1%) were incomplete. Among infectious emergencies, malaria led to 30 evacuations (10%) including 11 to intensive care units and one death before evacuation. Infectious diseases requiring medical evacuation were most often mild and community-acquired. Most soldiers were evacuated without medical assistance. CONCLUSIONS:Infectious diseases during missions and medical repatriations carried out for infectious reasons are important epidemiological indicators to monitor. They make it possible to adapt preventive measures, training, and diagnostic and therapeutic tools which can be made available to front-line military physicians.