Aviation-related injury morbidity and mortality: data from U.S. health information systems

Information about injuries sustained by survivors of airplane crashes is scant, although some information is available on fatal aviation-related injuries. Objectives of this study were to explore the patterns of aviation-related injuries admitted to U.S. hospitals and relate them to aviation deaths in the same period.

The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) contains information for approximately 20% of all hospital admissions in the United States each year. We identified patients in the HCUP NIS who were hospitalized during 2000-2005 for aviation-related injuries based on the International Classification of Diseases, 9th Revision, codes E840-E844. Injury patterns were also examined in relation to information from multiple-cause-of-death public-use data files 2000-2005.

Nationally, an estimated 6080 patients in 6 yr, or 1013 admissions annually (95% confidence interval 894-1133), were hospitalized for aviation-related injuries, based on 1246 patients in the sample. The average hospital stay was 6.3 d and 2% died in hospital. Occupants of non-commercial aircraft accounted for 32% of patients, parachutists for 29%; occupants of commercial aircraft and of unpowered aircraft each constituted 11%. Lower-limb fracture was the most common injury in each category, constituting 27% of the total, followed by head injury (11%), open wound (10%), upper extremity fracture, and internal injury (9%). Among fatalities, head injury (38%) was most prominent. An average of 753 deaths occurred annually; for each death there were 1.3 hospitalizations.

Aviation-related injuries result in approximately 1000 hospitalizations each year in the United States, with an in-hospital mortality rate of 2%. The most common injury sustained by aviation crash survivors is lower-limb fracture.