title: Injuries sustained after falls from bridges across the United States-Mexico border at El Paso.
abstract: OBJECTIVE
  To compare demographics and motivations for falls from bridges at the United States-Mexico border and in El Paso County, Texas, and to analyze injuries and injury patterns to support intentionality and to provide treatment recommendations.
  
  
  METHODS
  A retrospective observational review was conducted of hospital admissions to a trauma center after falls from bridges from 1995 to 2009. Statistical methods used were chi-square testing, T-test for means comparison, univariate correlations, and regression analysis.
  
  
  RESULTS
  Of the 97 evaluated patients, 81.4% fell from U.S.-Mexico border bridges, including one patient who fell from a railway bridge; 74.7% of those falling from border bridges had a non-U.S. address, contrasting with 22.2% of those who fell within the United States. Falls over the border were associated with more immigration-related motivations and fewer suicide attempts. Injuries included lower extremities in 76 (78.4%) and thoracolumbar spine in 27 (27.8%) patients; 16 patients with a thoracolumbar spine fracture (59.3%) also had a lower extremity injury. Mean hospital length of stay was 7.2 days. Mean injury severity score was 8.45 (range 1-43). Age, injury severity score, and pelvic fracture increased the hospital length of stay.
  
  
  CONCLUSIONS
  Patients fell while emigrating-immigrating based on residence and motivating factors. A dyad of lower extremity and thoracolumbar spine injuries coincided in 59.3% of those with a thoracolumbar spine injury; thoracolumbar spine imaging of patients evaluated after falls from bridges is recommended. Proposed prevention strategies include posting signs on bridges and installing catch-net safety barriers.
authors: Department of Surgery, Texas Tech University Health Sciences Center, El Paso, Texas, USA. susan.mclean@ttuhsc.edu
authors: Susan F
authors: SF
authors: McLean
authors: Alan H
authors: AH
authors: Tyroch
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology*; D016009:Chi-Square Distribution; D004641:Emigration and Immigration; D004779:Environment Design / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009042:Motivation; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult