title: Fixed-wing medical transport crashes: characteristics associated with fatal outcomes.
abstract: BACKGROUND
  Previous studies within the aeromedical literature have looked at factors associated with fatal outcomes in helicopter medical transport, but no analysis has been conducted on fixed-wing aeromedical flights. The purpose of this study was to look at fatality rates in fixed-wing aeromedical transport and compare them with general aviation and helicopter aeromedical flights.
  
  
  METHODS
  This study looked at factors associated with fatal outcomes in fixed-wing aeromedical flights, using the National Transportation Safety Board Aviation Accident Incident Database from 1984 to 2009.
  
  
  RESULTS
  Fatal outcomes were significantly higher in medical flights (35.6 vs. 19.7%), with more aircraft fires (20.3 vs. 10.5%) and on-ground collisions (5.1 vs. 2.0%) compared with commercial flights. Aircraft fires occurred in 12 of the 21 fatal crashes (57.1%), compared with only 2 of the 38 nonfatal crashes (5.3%) (P < .001). In the multiple logistic regression model, the only factor with increased odds of a fatal outcome was the presence of a fire (56.89; 95% CI, 4.28-808.23).
  
  
  CONCLUSIONS
  Similar to published studies in helicopter medical transport, postcrash fires are the primary factor associated with fatal outcomes in fixed-wing aeromedical flights.
authors.affiliation: Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 97239, USA. handeld@ohsu.edu
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Handel
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Yackel
mesh_terms: D000060:Accidents, Aviation / Q000145:classification / Q000401:mortality*; D017732:Air Ambulances / Q000145:classification*; D019992:Databases as Topic; D005390:Fires; D006801:Humans; D012189:Retrospective Studies