Border-fence falls versus domestic falls at a South Texas trauma center

Abstract

ObjectivesFalling from height may lead to significant injuries and time hospitalized; however, there are few studies comparing the specific mechanism of fall. The purpose of this study was to compare injuries from falls after attempting to cross the USA-Mexico border fence (intentional) with injuries from domestic falls (unintentional) of comparable height.MethodsThis retrospective cohort study included all patients admitted after a fall from a height of 15–30 ft to a level II trauma center between April 2014 and November 2019. Patient characteristics were compared by falls from the border fence with those who fell domestically. Fisher’s exact test, χ2test and Wilcoxon Mann-Whitney U test were used as appropriate. A significance level of α<0.05 was used.ResultsOf the 124 patients included, 64 (52%) were falls from the border fence while 60 (48%) were domestic falls. Patients sustaining injuries from border falls were on average younger than patients who had domestic falls (32.6 (10) vs 40.0 (16), p=0.002), more likely males (58% vs 41%, p<0.001), fell from a significantly higher distance (20 (20–25) vs 16.5 (15–25), p<0.001), and had a significantly lower median injury severity score (ISS) (5 (4–10) vs 9 (5–16.5), p=0.001). Additionally, compared with domestic falls, border falls had fewer injuries to the head (3% vs 25%, p=0.004) and chest (5% vs 27%, p=0.007), yet more extremity injuries (73% vs 42%, p=0.003), and less had an intensive care unit (ICU) stay (30% vs 63%, p=0.002). No significant differences in mortality were found.ConclusionPatients sustaining injuries from border crossing falls were slightly younger, and although fell from higher, had a lower ISS, more extremity injuries, and fewer were admitted to the ICU compared with patients sustaining falls domestically. There was no difference in mortality between groups.Level of evidenceLevel III, retrospective study.

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

“…Of the 108 patients, one patient died and 101 required surgical intervention. Previous research supports our conclusion that in border wall falls, there is a much higher predominance of lower extremity injuries [ 1 , 2 ]. Recent studies have associated the increased border height with falls resulting in more morbid and costly extremity, spine, and intracranial injuries [ 4 , 5 ].…”

“…However, the risk of crossing the border has only increased with time. A considerable share of admissions to trauma hospitals in border areas are due to injuries experienced from jumps or falls along the US-Mexico border [ 1 ]. These falls result in traumatic injuries with life-long consequences.…”

Spine Injuries Sustained After Falls While Crossing the U.S.-Mexico Border

“…Bracing for the fall may lead to increased axial loading, and these factors have been described as resulting in an increased rate of extremity and spine injuries in border wall falls. 22 Accidental falls from climbing aides may limit bracing and result in more variable injury patterns than those observed in the intentional fall mechanisms.…”

Traumatic Brain Injuries After Falls From Height vs Falls at the US-Mexico Border Wall

“…Previous studies have associated this 30-ft height extension with increased mortality and incidence of traumatic brain, spine, and cerebrovascular injuries . Another previous study compared border fall to general population injuries but predated the height extension . We aimed to characterize traumatic brain injuries (TBIs) and overall care associated with falls at the San Diego, California, border compared with general population falls, to guide future health care and border policies.…”