Outcomes of medical emergencies on commercial airline flights

N Engl J Med. 2013 May 30;368(22):2075-83. doi: 10.1056/NEJMoa1212052.

Abstract

Background: Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events.

Methods: We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death.

Results: There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77).

Conclusions: Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital. (Funded by the National Institutes of Health.).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aerospace Medicine / statistics & numerical data*
  • Aviation
  • Emergencies / classification
  • Emergencies / epidemiology*
  • Emergency Treatment / methods
  • Emergency Treatment / statistics & numerical data*
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / therapy
  • Humans
  • Male
  • Respiratory Tract Diseases / epidemiology
  • Respiratory Tract Diseases / therapy
  • Syncope / epidemiology
  • Syncope / therapy
  • Travel
  • Treatment Outcome