Patterns of injury amongst cruise ship passengers requiring hospitalisation

Background: The number of commercial cruise ship passengers continues to rise and is projected to reach27.2 million passengers worldwide in 2018. Accidental injury aboard these ships can result in serious morbidityand mortality. This study examines the injury mechanisms, patterns, demographics, and outcomesof 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 sustaininginjury while on a cruise ship admitted to a Level I Trauma Centre in the United States over a 2-yearperiod. Data on demographics, injury type and severity, surgical management, hospital charges, length ofstay, mortality, and discharge disposition were recorded.Results: Sixty seven patients were identified and included in the analysis. 70.1% of patients were 65 orolder and a majority were female (59.7%). The most common mechanism of injury was a ground levelfall (79.1%), and the most common injury encountered was a femur fracture (52.2%) which involved theacetabulo-femoral joint in 85.7% of cases. Traumatic brain injuries were uncommon occurring in 7.5% ofcases. There were no fatalities in this series.Conclusions: The most common injuries aboard cruise ships requiring hospitalisation occur in the geriatricpopulation as a result of a ground level fall. Most commonly, the injuries are long bone fractures, withfemur fractures occurring most frequently and accounting for over half of all injuries sustained. Resourcesand protocols for pre-hospital management of cruise ship injuries should prioritise these patients, and fallprevention measures for this demographic should be mandatory aboard all cruise ships