Injuries sustained after falls from bridges across the United States-Mexico border at El Paso

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.