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Author Notes:

Corresponding author: Email: chaudharys@email.chop.edu

Authors' contributions: SC contributed to all aspects of this article including literature search, conceiving study and study design, data collection, data analysis, data interpretation, and drafting the manuscript.

JF contributed to data analysis, data interpretation, tables and figs.

SS contributed to study design, data analysis, and data interpretation.

EWM contributed to study design, data interpretation, and drafting the manuscript.

RB contributed to study design, data collection, data interpretation, and drafting the manuscript.

MJ contributed to study design, data interpretation, and drafting the manuscript.

MLS contributed to study design, data interpretation, and drafting of the manuscript.

TPM contributed to study design, data analysis, data interpretation, and tables and figs.

JR contributed to study design, data analysis, data interpretation, and drafting the manuscript.

SN contributed to conceiving study and study design, data interpretation, and drafting the manuscript.

All authors read and approved final manuscript.

We would like to thank Karen Johnson, Coordinator, Children’s Healthcare of Atlanta Trauma Registry and the Division of Trauma Services for the data to conduct this study.

We would also like to thank the Injury Prevention Research Center at Emory Falls Task Force for providing oversight in this study.

Ethics approval and consent to participate: This study was approved by the CHOA IRB.

Consent for publication: Not applicable.

Competing interests: The authors declare that they have no competing interests.

Subjects:

Research Funding:

This study received no funding.

Publication of this article was funded by the Injury Free Coalition for Kids®.

Keywords:

  • Falls
  • Pediatrics
  • Unintentional

Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities.

Tools:

Journal Title:

Injury Epidemiology

Volume:

Volume 5, Number Suppl 1

Publisher:

, Pages 7-7

Type of Work:

Article | Final Publisher PDF

Abstract:

BACKGROUND: Pediatric unintentional falls are the leading cause of injury-related emergency visits for children < 5 years old. The purpose of this study was to identify population characteristics, injury mechanisms, and injury severities and patterns among children < 5 years 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 < 5 years 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 = 28 months; 59.7% male; 53.8% White; 49.1% <  1 m 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 = 49 months, p < 0.01) than those who fell from the bed (median = 10 months), stairs (median = 18 months), or furniture (median = 19 months). Children < 1 year 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 = 24.5 months, p < 0.01) than private payer (median = 34 months). Black patients were younger (median = 20.5 months, p < 0.001) than White patients (median = 29 months). 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 < 5 years. 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.

Copyright information:

© The Author(s). 2018

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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