Characterizing the frequency, morbidity, and types of traumatic brain injuries after the Mexico–San Diego border wall extension: a retrospective cohort review

Alexander Tenorio Department of Neurosurgery, University of California, San Diego;

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Michael G. Brandel Department of Neurosurgery, University of California, San Diego;

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Gautam R. Produturi School of Medicine, University of California, San Diego; and

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Carson P. McCann School of Medicine, University of California, San Diego; and

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Arvin R. Wali Department of Neurosurgery, University of California, San Diego;

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Javier Bravo Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, California

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Laura N. Godat Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, California

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Jay J. Doucet Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, California

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Todd W. Costantini Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California, San Diego, California

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David R. Santiago-Dieppa Department of Neurosurgery, University of California, San Diego;

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Joseph D. Ciacci Department of Neurosurgery, University of California, San Diego;

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Publication Date:
17 Feb 2023
Page Range:
848–853
Volume/Issue:
Volume 139: Issue 3
DOI link:
https://doi.org/10.3171/2023.1.JNS221859
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OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

This heightened risk of intracranial injury among vulnerable immigrant populations poses ethical and economic concerns to be addressed regarding border wall infrastructure.

ABBREVIATIONS

AIS = Abbreviated Injury Scale; CBP = Customs Border and Protection; EDH = epidural hematoma; ICU = intensive care unit; ISS = Injury Severity Score; LOS = length of stay; SDH = subdural hematoma; TBI = traumatic brain injury; UCSDH = UC San Diego Health; ZIP = zero-inflated Poisson.
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Cover Journal of Neurosurgery

Volume 139: Issue 3 (Sep 2023)

in Journal of Neurosurgery

Illustration from Mulford ert al. (pp 625–632). Published with permission from Glia Media, Artist: Tonya Hines, CMI.

Contributor Notes

Correspondence Joseph D. Ciacci: University of California, San Diego, CA. jciacci@health.ucsd.edu.

INCLUDE WHEN CITING Published online February 17, 2023; DOI: 10.3171/2023.1.JNS221859.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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