JMIR Publications

ABSTRACT

Background:

In-flight medical emergencies (IMEs) might cause severe outcomes, including the deaths of passengers or aircraft diversion. Information is lacking regarding the incidence and characteristics of IMEs for most countries, especially in mainland China.

Objective:

To investigate the frequency, pattern, and risk factors of IME occurrence in mainland China.

Methods:

This population-based retrospective study examined electronic records for all IME reports from a top-three major airline company between January 1, 2018 and December 31, 2022, on the mainland of China. Outcome variables included the medical category of the IMEs, the outcomes of first aid, and whether the IMEs led aircraft to an unscheduled landing (flight diversion) or not.

Results:

A total of 299 IMEs and 28 deaths occurred among 447.2 million passengers, yielding an incidence and all-cause mortality rate of 0.67 (95% confidence interval [CI]: 0.60-0.75) and 0.06 (95% CI: 0.04-0.09) per million passengers, respectively. The incidence of aircraft diversion was 42.50 (95% CI: 37.02-48.12) per million flights. Cardiac symptoms (15.7%), seizures (11.7%), and syncope or presyncope (8.0%) were the most common medical problems and main reasons for aircraft diversion. The leading cause of deaths was cardiopulmonary arrest (64.3%), which significantly increased the risk of death (adjusted odds ratio [aOR]: 55.66, 95% CI: 5.79–554.21). The age of 50–64 years (aOR: 3.98, 95% CI: 1.56–10.18) and the long flight ≥ 4000 km (aOR: 16.40, 95% CI: 1.78–151.29) were significantly associated with a higher risk of diversion.

Conclusions:

The occurrence and deaths of IMEs are rare in mainland China. The establishment of a unified reporting and registration system for IMEs is of great value to reduce IMEs and deaths in the global community.