Falling from new heights: Traumatic fracture burden and resource utilization after border wall height increase

From across the globe - traumatic injuries are an international concern at the US-Mexico border wall

Introduction

Socio-economic and political events of recent years have caused a significant increase in immigrants attempting to illegally cross the United States (US)-Mexico border. While a 30-foot border wall separates the US and Mexico, immigrants from around the world have used this location as their point of entry to the US. These border crossings have led to a dramatic increase in major trauma resulting in increased inpatient resource utilization and the need for comprehensive hospital services. The aim of this study was to describe the nationality of injured immigrants admitted to a Trauma Center serving a segment of the US-Mexico border wall and to report their ultimate destinations after discharge.

Methods

We performed a retrospective review of patients admitted to an academic, Level 1 Trauma Center after injury at the US-Mexico border wall from 2021 to 2022. Demographic information was obtained from the trauma registry. The electronic medical record was searched to identify each patient's self-reported country of origin. Patients' nationality was then stratified by region of the world to understand geographic representation of border injury admissions.

Results

We identified 597 patients injured while crossing the US-Mexico border wall representing 38 different countries. The mean age of patients was 32.2±10.4 years and 446 (75%) were male. Most patients (405, 67.8%) were Mexican, followed by 23 (3.9%) patients from Peru, 17 (2.8%) patients from India, 14 (2.3%) patients from El Salvador, 13 (2.2%) patients from Cuba and 12 (2.0%) patients from Jamaica. When considering regions of the world other than Mexico, patients were most commonly from Africa, South America and Central America.

Conclusion

The increased volume of trauma associated with the US-Mexico border wall is a humanitarian and health crisis.(1) The diverse national origin of patients admitted after injury from border wall falls has shed new light on the social and interpreter services needed to care for these border injury patients and the challenges that exist in their post-discharge care.

A Retrospective Study on the Outcomes of Injuries From Border Wall Falls

Objective Our retrospective cohort study focuses on the outcomes of injuries sustained from falls from the USA-Mexico border wall. The purpose of this study is to understand and predict the types of injuries that will be present in patients who fall from the border wall. This can further help trauma response teams to better predict and prepare for the care of these patients.  Methods  This retrospective cohort study included all patients that were admitted to Desert Regional Medical Center, a trauma I center, after a fall from the border wall that ranged from heights of 15 to 30 feet. The admissions occurred between March 2016 to December 2021.  Results  Of the 108 patients included, 38.2% (78) sustained at least one lower extremity injury, of which the most common was injury to the calcaneus bone. Additionally, there were several concomitant injuries, of which the combination of lower extremity and lumbar injury was found to be the most common (11.2%). The injury severity score (ISS) was found to not be statistically significant (ɑ=0.05) between groups of patients whose length of stay (LOS) in the hospital was greater than 10 days and less than 10 days. There was 1% fatality (1 of 108) and 92.5% required surgical intervention (100 of 108).  Conclusions Patients injured from border wall falls are more likely to sustain lower extremity injuries than injuries to other parts of the body. Additionally, patients with lower extremity injuries sustained lumbar spinal injuries concomitantly, which can be most likely attributed to the axial compression of the spine during these falls. Most of these injuries required surgery and hospital admissions to treat. Understanding the patterns of injury from border wall falls can further help trauma response teams treat patients with efficient management.

Rate of Aquatic and Maritime Drowning Deaths After US-Mexico Border Wall Height Increase

This study assesses migratory drowning deaths along the southwest border of the US before and after the increase in border wall height.

Increased Mortality and Morbidity Due to the Increase in Border Wall Height

Objective Our retrospective cohort study focuses on the differences in the severity of injuries sustained from border wall falls before and after wall height increase. Severity of injuries is categorized by injury severity score (ISS), length of stay in the hospital (LOS), ventilation, intensive care unit (ICU), and surgery. The purpose of this study is to underline the medical consequences of extending the US-Mexico border wall. Specifically, we focused on the severity of injuries that are seen in trauma centers near the US-Mexico border. We propose that the rise in trauma cases from the border wall is associated with the extension of the border wall.  Methods  This IRB-approved, retrospective cohort study included all patients that were admitted to Desert Regional Medical Center, a level 1 trauma center in Palm Springs, California, United States. Patients were admitted between March 2016 and December 2021, after sustaining a fall from the border wall. The fall of the height ranged from 15 to 30 feet. Patients were assigned to pre-2020 or post-2020 subgroups, based on time of admission. The total number of admissions, ISS, LOS, surgeries, ventilation, and ICU services were compared.  Results  Injuries from border wall falls grew 1250% from 2016 to 2021 (4 vs 50 admissions). When comparing the two subgroups, hospital admissions (20 vs 84) and ISS (9 vs 15) have also risen dramatically. Of all the variables compared, the days spent in the ICU proved to be statistically significant at a p-value of 0.02. Although the remaining data was not statistically significant, there still remains a trend of increasing injuries that are also more severe in presentation, requiring more interventions.  Conclusions The increase in border height has led to a record-high number of admissions and severity of injuries. This study shows that increasing the border wall height has led to a public health crisis and underlines the profound impact that political decisions have in the medical field.