In-Flight Medical Events on Commercial Airline Flights
Paulo M Alves1, Karan R Kumar2,3, Justin Devlin1
1MedAire, Inc, Phoenix, Arizona.
JAMA Network Open
|September 29, 2025
Summary
In-flight medical events are more common than previously thought, with neurologic and cardiac emergencies significantly increasing the likelihood of aircraft diversion. Physician volunteer involvement also raises diversion odds, impacting flight safety protocols.
Area of Science:
- Aviation Medicine
- Epidemiology
- Emergency Medicine
Background:
- In-flight medical events pose significant challenges due to limited resources and delayed care.
- Characterizing these events is crucial for improving passenger safety and airline protocols.
Purpose of the Study:
- To determine the frequency of in-flight medical events.
- To identify factors associated with aircraft diversion, hospital transport, and in-flight mortality.
Main Methods:
- A cohort study analyzed 77,790 in-flight medical events reported to a global medical support center (2022-2023).
- Data included clinical presentation, passenger demographics, and outcomes, with no exclusions.
- Statistical analyses identified variables linked to diversion, transport, and mortality.
Main Results:
- The incidence was 39 events per million enplanements.
- Aircraft diversion occurred in 1.7% of cases, primarily due to neurologic (41%) and cardiovascular (27%) conditions.
- Suspected stroke and acute cardiac emergencies showed the highest odds of diversion (AORs 20.35 and 8.16, respectively). Physician volunteer involvement also increased diversion odds (AOR 7.86).
Conclusions:
- In-flight medical events are more frequent than previously reported.
- Serious neurologic and cardiac conditions, along with physician volunteer presence, are associated with increased aircraft diversion.
- Findings can inform aviation policy, crew training, and diversion decision-making.
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