Association Between Time to Admission and Mortality in Physician-Led Medical Evacuations in Greenland

OBJECTIVE: Greenland presents unique challenges for medical evacuations due to its vast distances, Arctic weather, and limited infrastructure. The aim of this study was to assess whether the time from booking of an evacuation from any location in Greenland to the patient arrived at Queen Ingrid's Hospital (QIH) in the capital, Nuuk, was associated with mortality. It was hypothesized that a longer time interval was associated with a higher 30-day mortality.

METHODS: An observational cohort study was conducted to all medical evacuations attended by physicians from anywhere in Greenland to QIH in Nuuk, Greenland, between January 1, 2020, and July 31, 2024. Data were extracted from travel logs and medical records and included demographic information, evacuation details, and a 30-day outcome period. Logistic regression was used to compute odds ratios (ORs) associating the time interval from booking to admission with 30-day mortality.

RESULTS: Of 1303 records of patients identified through the travel logs, 690 patients met the inclusion criteria. The 30-day mortality was 7.5%, with the median time from booking to hospital admission of 7.9 hours (interquartile range 5.1-19.3). The unadjusted OR of 30-day mortality per hour from booking to admission at QIH was 0.99 (95% confidence interval [CI] 0.97-1.01; P = .50) and 1.00 (95% CI 0.96-1.02; P = .73) in the adjusted analysis.

CONCLUSIONS: In this study of all medical evacuations attended by physicians in Greenland in a 4.5-year period, there was no association between the time interval from booking to hospital admission at QIH in Nuuk and 30-day mortality.