1Department of Neurosurgery, University of California, San Diego.
2School of Medicine, University of California, San Diego; and.
J Neurosurg. 2023 Feb 17;139(3):848-853. doi: 10.3171/2023.1.JNS221859. Print 2023 Sep 1.
The aim of this study was to investigate the impact of the US-Mexico border wall height extension on traumatic brain injuries (TBIs) and related costs.
In this retrospective cohort study, patients who presented to the UC San Diego Health Trauma Center for injuries from falling at the border wall between 2016 and 2021 were considered. Patients in the pre-height extension period (January 2016-May 2018) were compared with those in the post-height extension period (January 2020-December 2021). Demographic characteristics, clinical data, and hospital charges were analyzed.
A total of 383 patients were identified: 51 (0 TBIs, 68.6% male) in the pre-height extension cohort and 332 (14 TBIs, 77.1% male) in the post-height extension cohort, with mean ages of 33.5 and 31.5 years, respectively. There was an increase in the average number of TBIs per month (0.0 to 0.34) and operative TBIs per month (0.0 to 0.12). TBIs were associated with increased Injury Severity Score (8.8 vs 24.2, p < 0.001), median (IQR) hospital length of stay (5.0 [2-11] vs 8.5 [4-45] days, p = 0.03), and median (IQR) hospital charges ($163,490 [$86,369-$277,918] vs $243,658 [$136,769-$1,127,920], p = 0.04). TBIs were normalized for changing migration rates on the basis of Customs and Border Protection apprehensions.
This heightened risk of intracranial injury among vulnerable immigrant populations poses ethical and economic concerns to be addressed regarding border wall infrastructure.
本研究旨在探讨美国-墨西哥边境墙增高对创伤性脑损伤（TBI）及相关费用的影响。
这是一项回顾性队列研究，纳入了 2016 年至 2021 年期间因跌落至美墨边境墙而到加州大学圣地亚哥卫生保健创伤中心就诊的患者。将 2016 年 1 月至 2018 年 5 月期间（即增高前时期）的患者与 2020 年 1 月至 2021 年 12 月期间（即增高后时期）的患者进行比较。分析了人口统计学特征、临床数据和住院费用。
共纳入 383 例患者：增高前时期 51 例（0 例 TBI，68.6%为男性），增高后时期 332 例（14 例 TBI，77.1%为男性），平均年龄分别为 33.5 岁和 31.5 岁。每月 TBI 发生率（0 至 0.34）和每月手术 TBI 发生率（0 至 0.12）均有所增加。TBI 与损伤严重程度评分升高（8.8 分比 24.2 分，p < 0.001）、中位（IQR）住院时间（5.0 [2-11]天比 8.5 [4-45]天，p = 0.03）和中位（IQR）住院费用（163490 美元[86369-277918 美元]比 243658 美元[136769-1127920 美元]，p = 0.04）相关。根据美国海关和边境保护局的截获数据，将不断变化的移民率纳入 TBI 进行归一化。
边境墙增高使脆弱的移民群体颅内受伤的风险增加，这对边境墙基础设施提出了伦理和经济方面的关注。
