Comparison of Heart and Aortic Injuries to Head, Neck, and Spine Injuries in US Army Aircraft Accidents from 1983 to 2005

Injuries to the heart and aorta occur predominantly in non-survivable helicopter accidents and are frequently observed concomitantly with head/neck and spine/pelvis injuries. Accidents which include all three of these injury patterns are often catastrophic where survivable cabin space was compromised. Published injury studies indicate that heart/aorta and other organ injuries are frequently seen in aviation fatalities, but their precise prevalence is unknown. This study reviews 156 US Army non-combat aviation accidents between CY83 and CY05, which includes 606 occupants and 2,533 injuries. Injury distributions by body region and body part are provided. We compare the relative frequency of accidents where head/neck, spine/pelvis, and heart/aorta injuries occur in at least a single occupant: head/neck (n=135; 87%), spine/pelvis (n=129; 83%), heart/aorta injury (HAI) (n=72; 46%). The combination of head/neck and spine/pelvis occurs in 37% of cases (n=58), and all three injury locations occurs in 37% of accidents (n=57). This study shows that HAI occurs most often in accidents where head/neck and spine/pelvis injuries also occur and that these outcomes are non-survivable. The association of HAI with injuries currently incorporated into design guidelines indicates that additional design requirements to mitigate against HAI are not warranted and that existing design criteria to mitigate head/neck and spine/pelvis injuries provide an adequate measure of the cabin crashworthiness.