Health and Economic Burden of Injurious Falls Into Irrigation Canals in Japan: A Retrospective Cohort Study.

Abstract

Falls into small water bodies can cause drowning and trauma. Such falls, especially into irrigation canals, and the subsequent trauma are common in Japan. However, few studies have investigated their characteristics, costs, and prognosis. Our aim was to clarify the characteristics, prognosis, and economic burden of trauma due to falls into irrigation canals in Kurashiki City, Japan. This 4-year, single-center, retrospective cohort study was conducted at a Japanese tertiary care hospital between January 1, 2013 and December 31, 2016. We enrolled patients who had fallen into irrigation canals constructed more than 300years ago, and transported to our hospital by ambulance. The study outcomes included the characteristics, prognosis, and health care costs of such trauma. We enrolled 266 patients with a median age of 66years (range 19-64years). Most patients fell into irrigation canals while walking (49.3%), riding a bicycle (35.0%), or driving or riding in a car (7.1%). Extremities were the most frequently affected body parts, and the head and chest were less frequently affected. Four patients (1.5%) died in the emergency department (ED), and 121 (45.5%) were hospitalized (109 in our hospital and 12 transferred to other hospitals). The total costs of ED and hospital stays were 777,625 US dollars (266 patients) and 712,059 US dollars (109 patients hospitalized in our hospital), respectively. Trauma due to falls into irrigation canals can be severe and even fatal, and the related costs are high. Our study highlights the importance of implementing appropriate measures to prevent falls into irrigation canals and of promoting awareness among citizens.