A multi-center review analyzing the effect of the United States-Mexico border height extension on neurological traumatic injuries

Introduction: The California-Mexico border wall height extension has been associated with an increase in spinal and traumatic brain injuries (TBI). In this multi-center study, we analyze whether these trends are occurring across the length of the US-Mexico border.

Methods: All patients who suffered a neurological injury due to a border wall fall and were treated at one of three trauma centers in Arizona, California, or Texas were included in our study. Patients were split into a pre-wall or a post-wall height extension group depending on date of their injuries. Continuous variables were analyzed using either t-tests or the Kruskal-Willis rank-rum test, and categorical variables were analyzed using chi-square analysis or Fisher’s exact test.

Results: 304 total patients were split into a pre-wall height extension cohort of 120 months and 52 patients (median age 29 years, 60% male) and a post-wall height extension cohort of 132 months and 252 patients (median age 30 years, 66% male). When normalized on a per-month basis, there were more spinal injuries (0.36 vs 1.76, p < 0.001) and TBIs (0.09 vs 0.33, p < 0.001) per month in the post-wall height extension cohort. The total number of neurological injuries per month (0.43 vs 1.91, p < 0.001) and operative neurological injuries per month (0.12 vs 0.57, p < 0.001) were also increased. These patients also had longer hospital lengths of stay (6 vs 8 days, p < .001), ICU lengths of stay (2 vs 3 days, p = 0.007), and increased hospital charges ($92,985 vs $221,905, p < 0.001).

Conclusion : The US-Mexico border wall modifications have resulted in increased neurological injuries and morbidity in a vulnerable population. This has strained border-serving hospitals as a significant proportion of these patients are uninsured. Policymakers should consider the health consequences and healthcare resource burden in future border legislation.