In 2009, a Boeing 737 crashed near Amsterdam, traumatically injuring 126 people. In trauma patients, some injuries initially escape detection. The aim of this study is to evaluate the incidence of Delayed Diagnosis of Injury (DDI) and the effects of tertiary survey on the victims of a plane crash.

Data collected included documentations of DDI, tertiary surveys, Injury Severity Scale (ISS) score, Glasgow Coma Scale score, number and type of injuries, and emergency intervention. Clinically significant injuries were separated from non-clinically significant injuries. Comparison was made to a crash in the UK (1989), before advanced trauma life support became practiced widely.

All 126 victims were evaluated in a hospital emergency department; 66 were admitted with a total of 171 clinically significant injuries. Twelve clinically significant DDIs were found in eight patients (12%). In 65%, a tertiary survey was documented. The DDI incidences differed for several risk factors. Eighty-one survivors of the UK crash had a total of 332 injuries. Of those with > 5 injuries, 5% had a DDI, versus 8% of those with ≤ 5 injuries.

The DDI incidence in this study was 7% of the injuries in 12% of the population. A tertiary survey was documented in 65%; ideally this should be 100%. In this study, a high ISS score, head injury, > 5 injuries, and emergency intervention were associated with DDI. The DDI incidence in the current study was lower than in the UK crash.