Vol 69, No 4 (2018)
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Published online: 2018-12-19

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Patterns of injury amongst cruise ship passengers requiring hospitalisation

William J. Isom1, Yves-Dany Accilien1, Stevenson B. Chery1, Dalier Mederos-Rodriguez2, John D. Berne2
Pubmed: 30589063
IMH 2018;69(4):243-247.


Background: The number of commercial cruise ship passengers continues to rise and is projected to reach
27.2 million passengers worldwide in 2018. Accidental injury aboard these ships can result in serious morbidity
and mortality. This study examines the injury mechanisms, patterns, demographics, and outcomes
of these injuries which are serious enough to require hospitalisation in order to facilitate administrative,
financial, and medical decision making to aid in injury prevention and treatment.
Materials and methods: This is a cross-sectional, retrospective, registry-based study of adult patients sustaining
injury while on a cruise ship admitted to a Level I Trauma Centre in the United States over a 2-year
period. Data on demographics, injury type and severity, surgical management, hospital charges, length of
stay, mortality, and discharge disposition were recorded.
Results: Sixty seven patients were identified and included in the analysis. 70.1% of patients were 65 or
older and a majority were female (59.7%). The most common mechanism of injury was a ground level
fall (79.1%), and the most common injury encountered was a femur fracture (52.2%) which involved the
acetabulo-femoral joint in 85.7% of cases. Traumatic brain injuries were uncommon occurring in 7.5% of
cases. There were no fatalities in this series.
Conclusions: The most common injuries aboard cruise ships requiring hospitalisation occur in the geriatric
population as a result of a ground level fall. Most commonly, the injuries are long bone fractures, with
femur fractures occurring most frequently and accounting for over half of all injuries sustained. Resources
and protocols for pre-hospital management of cruise ship injuries should prioritise these patients, and fall
prevention measures for this demographic should be mandatory aboard all cruise ships.

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  1. DiMaggio C, Ayoung-Chee P, Shinseki M, et al. Traumatic injury in the United States: In-patient epidemiology 2000-2011. Injury. 2016; 47(7): 1393–1403.
  2. 10 Leading Causes of Injury Deaths by Age Group Highlighting Unintentional Injury Deaths, United States – 2017. National Center for Health Statistics. National Center for Injury Prevention and Control. 2017: CDC.
  3. Kennedy S. 2018 Cruise Industry Outlook. Cruise Lines International Association, Inc. December. 2017.
  4. North American Cruise Statistical Snapshot. U.S. Department of Transportation, Maritime Administration. North American Cruises 2011 Kennedy S. 2017 Cruise Industry Outlook. Cruise Lines International Association, Inc. December. 2016.
  5. American College of Emergency Physicians. Health Care Guide-lines for Cruise Ship Medical Facilities. https://www.acep.org/Content.aspx?id+29980#sm.0001qn8pz86eje4ivyk2cvbosjuan (Revised July 2014).
  6. Committee on Trauma. National Trauma Data Standard Data Dictionary 2018 Admissions, Chicago, IL, American College of Surgeons. 2018.
  7. Data Dictionary. Florida Trauma Registry Manual. Florida Health. 2016: Edition.
  8. Bansal V, Fortlage D, Lee JG, et al. Significant injury in cruise ship passengers a case series. Am J Prev Med. 2007; 33(3): 219–221.
  9. Hudson D, Nilsen P, Dahl E, et al. Factors Associated With Injuries Occurring Aboard Vessels in Alaska: Differences Between Residents and Nonresidents. Journal of Travel Medicine. 2006; 13(2): 67–72.
  10. Dahl E. Passenger accidents and injuries reported during 3 years on a cruise ship. Int Marit Health. 2010; 61(1): 1–8.
  11. Bekic M, Mikolaucic M, Golubovic M, et al. A three-year follow-up on injuries sustained by cruise ship passengers and crew treated at the Orthopaedic and Traumatology Department at Dubrovnik County Hospital. Injury. 2015; 46 Suppl 6: S73–S77.
  12. Orces C. Hip Fracture-Related Mortality among Older Adults in the United States: Analysis of the CDC WONDER Multiple Cause of Death Data, 1999–2013. Epidemiology Research International. 2016; 2016: 1–5.