• Lam Rex Pui Kin RPK Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Accident and Em, Ronald Tat Ming Wong, Eric Ho Yin Lau, Kin Wa Wong, Arthur Chi Kin Cheung, Vi Ka Chaang, Lujie Chen, Tat Chi Tsang, Tak Kuen Chan, Peter Pay Yun Chee, Frank Hiu Fai Ko, Chin San Leung, and Siu Ming Yang.
• Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Accident and Emergency Department, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China. Electronic address: lampkrex@hku.hk.
• Injury. 2020 Feb 1; 51 (2): 252-259.

BackgroundAccidents involving high-speed passenger ferries have the potential to cause mass-casualty incidents (MCIs), yet there is a lack of relevant studies available to inform hospital disaster preparedness planning.ObjectiveThe objective was to study the injury patterns and outcomes of MCI victims involved in high-speed passenger ferry accidents in Hong Kong waters.MethodsA retrospective study was conducted from 1 January 2005 to 31 December 2015. All MCIs involving high-speed passenger ferries were captured from the Marine Department of Hong Kong. Victims of all age who were sent to the accident and emergency departments (A&Es) of seven public hospitals around Victoria Harbour, including three trauma centres, were identified from electronic disaster registries of the study hospitals. Data on injury patterns and outcomes were extracted from medical records with the Injury Severity Score (ISS) calculated for each victim. The Kruskal-Wallis test was used to compare medians of the ISS across different mechanisms of injury. Multivariable logistic regression was performed to identify independent predictors for major trauma (ISS≥16).ResultsDuring the study period, eight MCIs involving high-speed passenger ferries were reported and 512 victims (median age: 44 years, age range: 2-85 years) were sent to the study hospitals. The A&E triage categories were Cat 1, 3.1%; Cat 2, 4.3%; Cat 3, 19.3%; Cat 4, 72.9%; and Cat 5, 0.4%, respectively. The median ISS was 1.0 (interquartile range: 1.0-2.0). Fourteen victims (2.7%) had an ISS≥16 and age was the only independent predictor for major trauma (OR 1.06, p = 0.025, 95% CI 1.01-1.11). Trauma call was activated at A&E for 11 victims. In total, 100 victims (19.5%) were admitted to the study hospitals, including 19 (3.5%) and 15 (2.9%) who required surgery and intensive care unit stay, respectively. Eleven victims (2.1%) died, mostly due to drowning.ConclusionMCIs involving high-speed passenger ferries can result in a sudden surge in demand for both A&E and in-patient care, though the majority of victims may have minor injuries. Better access to lifejackets and mandatory seatbelt use may help to reduce injuries and deaths.Copyright © 2019. Published by Elsevier Ltd.

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