Standardized Fitness-to-Fly Assessment for Neurosurgical Patient Repatriation from the United Arab Emirates : A Comprehensive Framework

Background:The United Arab Emirates (UAE) has a large expatriate population, with approximately 88% of residents being nonnationals.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 conditionspecific 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.