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      The impact of the Mexico–San Diego border wall extension on spine injuries: a retrospective cohort review

      , , , , , ,
      Journal of Travel Medicine
      Oxford University Press (OUP)

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          Abstract

          Background

          The recent San Diego–Mexico border wall height extension has resulted in an increased injury risk for unauthorized immigrants falling from greater heights. However, the effects of the border wall extension on frequency and morbidity of spinal injuries and related economic costs have yet to be highlighted.

          Methods

          We retrospectively compared two cohorts who presented to the UC San Diego Health Trauma Center for border wall falls: pre-height extension (12 patients; January 2016–May 2018), and post-height extension (102 patients; January 2020–December 2021). Patients presented during border wall construction (June 2018–December 2019) were excluded. Demographics, clinical data and hospital costs were collected. Spinal injuries were normalized using Customs and Border Protection apprehensions. Costs were adjusted for inflation using the 2021 medical care price index.

          Results

          The increase in spine injuries per month (0.8–4.25) and operative spine injuries per month (0.3– 1.7) was statistically significant (P < 0.001). Increase in median length of stay from 6 [interquartile range (IQR) 2–7] to 9 days (IQR 6–13) was statistically significant (P = 0.006). Median total hospital charges increased from $174 660 to $294 421 and was also significant (P < 0.001).

          Conclusion

          The data support that the recent San Diego–Mexico border wall extension is correlated with more frequent, severe and costly spinal injuries. This current infrastructure should be re-evaluated as border-related injuries represent a humanitarian and public health crisis.

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          Most cited references14

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          A wilcoxon-type test for trend

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            Association of 30-ft US-Mexico Border Wall in San Diego With Increased Migrant Deaths, Trauma Center Admissions, and Injury Severity.

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              Is Open Access

              The mechanism and pattern of injuries of undocumented immigrants crossing the Texas-Mexico border along the Rio Grande Valley

              Background Apprehensions of undocumented immigrants in the Rio Grande Valley sector of the U.S.-Mexico border have grown to account for nearly half of all apprehensions at the border. The purpose of this study is to report the prevalence, mechanism, and pattern of traumatic injuries sustained by undocumented immigrants who crossed the U.S.-Mexico border at the Rio Grande Valley sector over a span of 5 years and were treated at a local American College of Surgeons verified Level II trauma center. Methods A retrospective chart review was conducted from January 2014 to December 2019. Demographics, comorbidities, injury severity score (ISS), mechanism of injury, anatomical part of the body affected, hospital and ICU length of stay (LOS), and treatment costs were analyzed. Descriptive statistics for demographics, injury location and cause, and temporal trends are reported. The impact of ISS or surgical intervention on hospital LOS was analyzed using an analysis of covariance (ANCOVA). Results Of 178 patients, 65.2% were male with an average age of 31 (range 0–67) years old and few comorbidities (88.8%) or social risk factors (86%). Patients most commonly sustained injuries secondary to a border fence-related incident (33.7%), fleeing (22.5%), or motor vehicle accident (16.9%). There were no clear temporal trends in the total number of patients injured, or in causes of injury, between 2014 and 2019. The majority of patients (60.7%) sustained extremity injuries, followed by spine injuries (20.2%). Border fence-related incidents and fleeing increased risk of extremity injuries (Odds ratio (OR) > 3; p   <  0.005), whereas motor vehicle accidents increased risk of head and chest injuries (OR > 4; p   <  0.004). Extremity injuries increased the odds (OR: 9.4, p  < 0.001) that surgery would be required. Surgical intervention was common (64%), and the median LOS of patients who underwent surgery was 3 days more than those who did not ( p  < 0.001). Conclusion In addition to border fence related injuries, undocumented immigrants also sustained injuries while fleeing and in motor vehicle accidents, among others. Extremity injuries, which were more likely with border fence-related incidents, were the most common type. This type of injury often requires surgical intervention and, therefore, a longer hospital stay for severe injuries.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Journal of Travel Medicine
                Oxford University Press (OUP)
                1195-1982
                1708-8305
                September 27 2022
                September 27 2022
                Article
                10.1093/jtm/taac112
                36165623
                052619d0-08f2-42e1-9cb5-2e5b6b7633ad
                © 2022
                History

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