Original Contribution
Age variability in pediatric injuries from falls,☆☆

https://doi.org/10.1016/j.ajem.2011.12.001Get rights and content

Abstract

Objective

The objective of this study is to examine the nature and circumstances surrounding pediatric fall-related injuries for specific age groups and their implications for age-appropriate injury prevention efforts.

Methods

This is a retrospective analysis of data (October 2006 to April 2009) from the trauma registry of a level 1 pediatric trauma center. Inclusion criteria are patients admitted because of fall-related injury younger than 15 years (n = 675). Injury mechanism specifics were obtained from medical records.

Results

Falls were the leading cause of admissions and accounted for 37% of all cases during this period. Most pediatric fall-related injuries (73%) occurred between 1 and 9 years of age. Although infants accounted for only 8% of fall injuries, a greater proportion of these children were more severely injured. The mean Injury Severity Score for infants was significantly greater than the overall average (P < .001). Causes of fall injuries vary by age and have been discussed.

Conclusions

The high incidence of pediatric fall injuries warrants dedicated injury prevention education. Injury prevention efforts need to be age appropriate in terms of focus, target audience, and setting. Recommendations for injury prevention are discussed.

Introduction

Falls are the most common cause of unintentional injuries among children. Each year, approximately 2.8 million children had an initial emergency department (ED) visit for injuries from a fall [1]. Previous studies on pediatric falls have addressed specific types of falls, such as falls from balconies [2], windows [3], [4], and falls in bathtubs [5]. There is limited research on understanding patterns of fall injuries that may exist across different age groups. This article provides a systematic examination of pediatric falls and their variations by age.

As children go through development stages, their exposure to and interaction with hazardous situations vary [6]. This research would identify leading causes of pediatric fall injuries by age. Knowledge of these causes would be useful in developing age-specific fall injury prevention efforts. Fall injury prevention typically does not often receive the same precedence as other injuries. It is often bundled with home safety education [7]. Studies have suggested that parents and caregivers may be unable to assimilate large amounts of diverse and often complicated information pertaining to injury prevention. Therefore, simple, well-targeted interventions would likely prove most effective [7], [8], [9]. Although pediatric falls have lower mortality compared with motor vehicle crashes, drowning, and burns, they are nevertheless significant in terms of physical, emotional, and financial consequences and mandate focused injury prevention initiatives.

Section snippets

Methods

A retrospective analysis of data from the trauma registry of a level 1 pediatric trauma center between October 2006 and April 2009 was done. Only patients younger than 15 years, admitted because of fall-related injury (E-codes E880-E888, principal diagnosis, International Classification of Diseases, Ninth Revision Code, 2010) were included. Injuries from bicycles (E826), sports (E917), and child abuse (E967) were not included. Medical charts for these patients were examined to gain a better

Results

For the 31-month period, falls were the leading cause of injuries for all age groups. The 675 hospitalizations from falls accounted for 37% of all cases in the trauma registry. Most patients (81%) were younger than 10 years. There were no fatalities from falls. The length of hospitalization ranged from 1 to 19 days with a mean of 1.5 days (interquartile range, 1-2 days). Patient characteristics are described in Table 1.

The main sites for injury from falls were in and around homes (56%);

Discussion

Falls are the leading cause of pediatric injuries. However, injury prevention efforts often do not reflect the significance of this problem. Research suggests that mothers perceived that society viewed falls by children as normative and that there was little expectation for parents to prevent them [10]. However, most fall-related injuries are preventable.

With a few exceptions [11], [12], studies on pediatric falls have focused on specific types of falls [2], [3], [4], [5] rather than injury

Conclusions

The circumstances of pediatric falls vary by age. It is important to look beyond E-codes to gain a better understanding of the causes of injuries from falls in children. Our study findings suggest that interventions to prevent injuries from falls should receive priority and be targeted by age group.

References (21)

  • J. Gaines et al.

    Recognition of home injury risks by novice parents of toddlers

    Accid Anal Prev

    (2009)
  • N.N. Borse et al.

    CDC Childhood Injury Report: patterns of unintentional injuries among 0-19 year olds in the United States, 2000-2006

    (2008)
  • B.J. Shields et al.

    Epidemiology of balcony fall-related injuries, United States, 1990-2006

    Am J Emerg Med

    (2010)
  • C.N. Spiegel et al.

    Children can't fly: a program to prevent childhood morbidity and mortality from window falls

    Am J Public Health

    (1977)
  • R. Benoit et al.

    Windows 99: a source of suburban pediatric trauma

    J Trauma

    (2000)
  • S.J. Mao et al.

    Injuries associated with bathtubs and showers among children in the United States

    Pediatrics

    (2009)
  • B. Savitsky et al.

    Variability in pediatric injury patterns by age and ethnic groups in Israel

    Ethn Health

    (2007)
  • J.C. Posner et al.

    A randomized clinical trial of a home safety intervention based in an emergency department setting

    Pediatrics

    (2004)
  • W.A. Altemeier

    Prevention of pediatric injuries: so much to do, so little time

    Pediatr Ann

    (2000)
  • C. DiGuiseppi et al.

    Individual-level injury prevention strategies in the clinical setting

    Future Child

    (2000)
There are more references available in the full text version of this article.

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No grant or funds were used for this article.

☆☆

Presented at Annual Meeting of the American Public Health Association (Poster), November 2010.

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