Anatomy of a World Cruise

Background and Method:We registered the patient-related activities of a large cruise ship's medical center during a 103-day worldwide voyage and compared data from 694 passengers (53% women) with median age 66 years with data from 540 crew (27% women) with median age 30 years of age. Results:The medical staff had 3033 (1537 crew, 1496 passenger) consultations (=206 consultations per week) and performed 982 diagnostic procedures. Skin disorders dominated in the crew and were more frequent than in the passengers (29% versus 13%, p<.01), respiratory problems dominated in the passengers and were more frequent than in the crew (26% versus 17%, p<.01), while cardiovascular disorders were more common in the passengers (7% versus 1%, p<.01). Forty-six injuries (35 passengers, 11 crew) were recorded. One passenger died aboard. Seventy-six crew (14%) were not able to work for a total of 110 days (1.1 crew sick per day), while five crew were signed off for medical reasons. Conclusions:To be a doctor or nurse on a large cruise ship during a long sea voyage is no vacation. The medical staff should expect a varied general practice with a higher consultation frequency rate than shoreside, even higher in crew than in passengers. Respiratory and skin problems are common, but the medical staff must be particularly prepared to handle injuries and acute cardiopulmonary crises.