An analysis of air-crash injury patterns presenting at a level 1 trauma unit in Johannesburg, a retrospective cohort study

BACKGROUND: In the twenty-first century, transportation disasters and subsequent injuries are on the rise, in particular air travel, and, thus, contributing significantly to the morbidity and mortality. Aviation injuries are not common in South Africa, injuries and outcomes of patients involved in aircraft crashes are unknown. We aimed to describe the injury patterns, and mortality rate resulting from air crashes presenting at a level 1 trauma centre in Johannesburg, South Africa. METHODS: Data was collected between January 2011 and December 2019. The hospital trauma database was used to obtain data related to patients who were involved in aircraft crashes. Their demographics, type of related aircraft, injuries sustained, injury severity score (ISS), new injury severity score (NISS), revised trauma score (RTS) surgical intervention carried out, length of stay in ICU, length of hospital stay, morbidities, 28-day mortality and outcomes (discharge/death). RESULTS: Fifty-two (52) patients (mean age was 44,8 years) were identified. The mean ISS was 9, and NISS was 11. Patients were occupants of civilian, non-commercial, powered aircraft. Fixed wing constituted 63,46%, followed by helicopters 21,15% and 7,69%. Spinal injuries were the most common injury in our patients, followed by soft tissue injuries and rib fractures. The median hospital stay was 10 ± 22 days. The overall in-hospital mortality rate was 7.7 % CONCLUSION: Majority of patients sustained musculoskeletal injuries. We suggest that these injured patients should be managed at a Level 1 facility in view of combined multiple injuries sustained during the crash.