title: Significant injury in cruise ship passengers a case series.
abstract: BACKGROUND
  The attention placed on cruise ship infectious epidemics has helped create important preventive strategies in improving food handling, sanitation, and overall cruise ship medical care. However, the incidence of serious injury in cruise ship passengers has never been fully described. In 2006, there was an increase in the number of cruise ship passengers receiving medical care at a Level I trauma center. This report provides a case series analysis of eight patients identified as suffering from significant cruise ship-related injuries.
  
  
  METHODS
  A retrospective, descriptive study design was used. Data on trauma patients transported directly from cruise ships and admitted to a university Level I trauma center in 2003-2006 were reviewed.
  
  
  RESULTS
  A total of 2,132 patients were admitted as major trauma resuscitations in 2006. Eight were identified as being injured on a major cruise ship compared to an average of 1.7 patients/year in the preceding 3 years. All but one patient was female. Three patients had significant medical comorbidities. All eight patients suffered injuries from falls, five of which were in stairwells. Concussions were the most common injury. Five patients were discharged to home, two to extended rehabilitation facilities, and one died.
  
  
  CONCLUSIONS
  In this case series, falls were the sole cause of major injury among cruise ship passengers. Improved surveillance and characterization of injuries among cruise ship passengers is needed to inform safety policies and develop programs to prevent passenger injury.
authors.affiliation: University of California San Diego, Department of Surgery, Division of Trauma, Burns and Critical Care, San Diego, California 92103, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Bansal
authors.forename: Dale
authors.initials: D
authors.lastname: Fortlage
authors.forename: Jeanne G
authors.initials: JG
authors.lastname: Lee
authors.forename: Linda L
authors.initials: LL
authors.lastname: Hill
authors.forename: Bruce
authors.initials: B
authors.lastname: Potenza
authors.forename: Raul
authors.initials: R
authors.lastname: Coimbra
mesh_terms: D000058:Accidental Falls / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001924:Brain Concussion / Q000209:etiology* / Q000628:therapy; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation; D012189:Retrospective Studies; D012767:Ships; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000209:etiology* / Q000628:therapy