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

Abstract

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.

Musculoskeletal injuries sustained at the California, USA: Baja California, Mexico border

“…Among our patient population, lower extremity injuries were the most common injury type (46%) which is consistent with prior studies conducted at the Texas–Mexico border, and lower extremity injuries occurred 58–60.7% of the time (Burk et al 2017 ; Palacio et al 2021 ). In our population, lower extremity injuries had an average of 1.6 ± 1.4 procedures, including application of external fixators for stabilization of the injury.…”

“…Injury patterns vary and depend on fall height, accidental versus non-accidental fall pattern, mechanism of landing, and landing surface (Con et al 2014 ; Papadakis et al 2020 ; Rowbotham et al 2019 ). Prior work by Burk and Palacio showed that in El Paso and the Rio Grande Valley, Texas, the injuries experienced by individuals crossing the US–Mexico border were among mostly men and predominantly involved the spine and lower extremity (Burk et al 2017 ; Palacio et al 2021 ). Consistent with this work, Koleski et al have shown that musculoskeletal injuries are the primary reason for medical attention following crossing the US–Mexico border (Koleski et al 2019 ); and in San Diego, the number of patients treated for injuries while crossing the border continue to increase, with the most recent increase in border wall height associated with higher numbers of deaths, injury severity scores, and burden of complex injured patients (Kelada et al 2010 ; Liepert et al 2022 ).…”

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

“…The new 30-ft border wall was reported in lay media to be unclimbable. However, our level 1 trauma center experienced significant increases in the number and severity of patients with border wall fall injuries starting in 2019, as new wall construction concluded . We sought to characterize the changes in morbidity and mortality of border wall fall injuries after construction of the 30-ft border wall in San Diego and Imperial Counties, California.…”

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

“…Injuries sustained from jumps or falls at the USA-Mexico border account for a significant proportion of admissions at trauma centers in border states 1–6. Although previous studies on falls from heights have demonstrated that an increase in the height fallen has been associated with worse outcomes and a higher rate of mortality,7–10 most of the focus was on the difference in height as opposed to the difference in mechanism of fall.…”

“…Additionally, the literature is scarce when it comes to evaluating the difference between domestic versus border crossing-related falls. Previous studies evaluated the different types of injuries sustained by immigrants crossing the border but did not address similar falls domestically, which can also lead to significant morbidity and mortality at trauma centers 1–10…”