BACKGROUND: Pediatric unintentional falls are the leading cause of injury-related emergency visits for children <5years old. The purpose of this study was to identify population characteristics, injury mechanisms, and injury severities and patterns among children <5years to better inform age-appropriate falls prevention strategies. METHODS: This retrospective database study used trauma registry data from the lead pediatric trauma system in Georgia. Data were analyzed for all patients <5years with an international classification of disease, 9th revision, clinical modification (ICD-9 CM) external cause of injury code (E-code) for unintentional falls between 1/1/2013 and 12/31/2015. Age (months) was compared across categories of demographic variables, injury mechanisms, and emergency department (ED) disposition using Kruskal-Wallis ANOVA and the Mann Whitney U test. The relationships between demographic variables, mechanism of injury (MOI), and Injury Severity Score (ISS) were evaluated using multinomial logistic regression. RESULTS: Inclusion criteria were met by 1086 patients (median age=28months; 59.7% male; 53.8% White; 49.1%<1m fall height). Younger children, <1-year-old, primarily fell from caregiver's arms, bed, or furniture, while older children sustained more falls from furniture and playgrounds. Children who fell from playground equipment were older (median=49months, p<0.01) than those who fell from the bed (median=10months), stairs (median=18months), or furniture (median=19months). Children <1year had the highest proportion of head injuries including skull fracture (63.1%) and intracranial hemorrhage (65.5%), 2-year-old children had the highest proportion of femur fractures (32.9%), and 4-year-old children had the highest proportion of humerus fractures (41.0%). Medicaid patients were younger (median=24.5months, p<0.01) than private payer (median=34months). Black patients were younger (median=20.5months, p<0.001) than White patients (median=29months). Results from multinomial logistic regression models suggest that as age increases, odds of a severe ISS (16-25) decreased (OR=0.95, CI=0.93-0.97). CONCLUSIONS: Pediatric unintentional falls are a significant burden of injury for children <5years. Future work will use these risk and injury profiles to inform current safety recommendations and develop evidence-based interventions for parents/caregivers and pediatric providers.
Chaudhary, S., Figueroa, J., Shaikh, S., Mays, E. W., Bayakly, R., Javed, M., ... Nieb, S.
citation count
38
complete list of authors
Chaudhary, Sofia||Figueroa, Janet||Shaikh, Salah||Mays, Elizabeth Williams||Bayakly, Rana||Javed, Mahwish||Smith, Matthew Lee||Moran, Tim P||Rupp, Jonathan||Nieb, Sharon
