Amin Abdulwahab Alsattouf*

Department of Neurosurgical, SKMCA/Ajman, UAE

*Corresponding Author: Amin Abdulwahab Alsattouf, Department of Neurosurgical, SKMCA/Ajman, UAE.

Received: June 04, 2025; Published: June 16, 2025

Abstract

Background: The United Arab Emirates (UAE) has a large expatriate population, with approximately 88% of residents being non-nationals. This demographic reality creates a significant need for international patient repatriation following neurosurgical interventions. Despite this need, there is a lack of standardized guidelines for assessing fitness-to-fly in neurosurgical patients requiring repatriation.

Objective: To develop a comprehensive framework and condition-specific protocols for assessing fitness-to-fly in neurosurgical patients requiring repatriation from UAE hospitals to their home countries.

Methods: A systematic review of literature on aeromedical evacuation of neurosurgical patients was conducted, followed by analysis of current repatriation forms and policies. Based on this research, a standardized assessment framework and condition-specific protocols were developed for five common neurosurgical conditions: post-operative cases, traumatic brain injury, stroke, cerebrospinal fluid leaks, and spinal injuries. The framework was validated through expert review by senior neurosurgeons with experience in international patient transfers.

Results: The research identified significant gaps in existing repatriation guidelines for neurosurgical patients. The developed framework addresses these gaps through a comprehensive assessment approach that considers physiological, logistical, and condition-specific factors. Condition-specific protocols provide detailed guidance on timing considerations, critical assessment parameters, and transport method selection.

Conclusion: The standardized assessment framework and condition-specific protocols presented in this paper provide UAE neurosurgeons with evidence-based tools for evaluating fitness-to-fly in neurosurgical patients requiring repatriation. Implementation of these guidelines can improve patient safety during repatriation while standardizing the assessment process across practitioners.

Keywords: Neurosurgery; Patient Repatriation; Aeromedical Evacuation; Fitness-To-Fly; United Arab Emirates; Expatriate Healthcare; Air Travel; Medical Clearance

References

1. Snoj J. “UAE's population – by nationality”. BQ Magazine (2015).
2. Central Intelligence Agency. United Arab Emirates. The World Factbook (2023).
3. Martin-Gill C., et al. “In-flight medical emergencies: A review”. JAMA 24 (2018): 2580-2590.
4. Aerospace Medical Association. Medical Guidelines for Airline Travel, 2^nd edition”. Aviation, Space, and Environmental Medicine 5 (2003): A1-19.
5. Bichsel O., et al. “Air travel with pneumocephalus: a systematic review”. Acta Neurochirurgica (Wien) 9 (2022): 2395-2400.
6. Netzer N., et al. “Hypoxia-related altitude illnesses”. The Journal of Travel Medicine 4 (2013): 247-255.
7. Adi Y., et al. “The association between air travel and deep vein thrombosis: systematic review and meta-analysis”. BMC Cardiovascular Disorders 4 (2004): 7.
8. International Air Transport Association (IATA). Medical Manual, 11^th Montreal: IATA (2018).
9. Donovan DJ., et al. “Aeromedical evacuation of patients with pneumocephalus: outcomes in 21 cases”. Aviation, Space, and Environmental Medicine 1 (2008): 30-35.
10. Amato-Watkins A., et al. “Air travel after intracranial surgery: a survey of advice given to patients by consultant neurosurgeons in the UK”. British Journal of Neurosurgery1 (2013): 9-11.
11. Goodman MD., et al. “Traumatic brain injury and aeromedical evacuation: when is the brain fit to fly?” The Journal of Surgical Research 2 (2010): 286-293.
12. Kouliev T., et al. “Intracranial hemorrhage during aeromedical transport and correlation with high altitude adaptations in the brain”. Open Access Emergency Medicine 4 (2012): 93-95.
13. Al-Khindi T., et al. “Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage”. Stroke 8 (2010): e519-e536.
14. Alali AS., et al. “Intracranial pressure monitoring in severe traumatic brain injury: results from the American College of Surgeons Trauma Quality Improvement Program”. Journal of Neurotrauma20 (2013): 1737-1746.v
15. Josephs LG., et al. “Diagnostic laparoscopy increases intracranial pressure”. Journal of Trauma 6 (1994): 815-818.

Citation

Citation: Amin Abdulwahab Alsattouf. “Standardized Fitness-to-Fly Assessment for Neurosurgical Patient Repatriation from the United Arab Emirates : A Comprehensive Framework".Acta Scientific Neurology 8.7 (2025): 03-13.

Copyright

Copyright: © 2025 Amin Abdulwahab Alsattouf. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.