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Fall-Down Injuries in children in Treated at the Emergency Department; Preventable Aspects  

Kim, Sun-Deok (Department of Emergency Medicine, School of Medicine, Ewha Womans University)
Jung, Si-Young (Department of Emergency Medicine, School of Medicine, Ewha Womans University)
Jung, Koo-Young (Department of Emergency Medicine, School of Medicine, Ewha Womans University)
Publication Information
Journal of Trauma and Injury / v.23, no.2, 2010 , pp. 96-101 More about this Journal
Abstract
Purpose: This study was conducted in order to evaluate the epidemiological characteristics of?children with fall-down injuries according to age groups and to analyze the major trauma groups that were treated at the emergency room (ER). Methods: Among 1,222 children under age 6 who were treated at the ER from January 2008 to December 2009, a retrospective study was conducted through examination of medical records. The children were classified by age into 3 groups: infant, toddler, and pre-schooler. In each group, the differences between the causative factors that led to the fall-down injuries were analyzed. Also, ISS (Injury Severity Score) score above 4 was classified as major trauma, and an ISS score 0-1 was classified as a minor trauma. The relationship between major trauma and age group was also analyzed. Results: Through an analysis of child fall-down injuries, men (56.6%), toddler (47.3%), head-related symptoms (72.9%), furniture-related traumas (80.2%), and falls from less than a 1-m height (69.9%) were found to be common factors. Furthermore, in radiological studies, fractures and brain hemorrhages accounted for 16.9% of major traumas, and simple skull fractures were the most common (21.4%). Distributed according to age group, the factors relevant to fall injuries were fall height and head-related symptoms for infants, accident site, fall height and head-related symptoms for toddlers, and accident site for pre-schoolers (p<0.05). Also, headrelated symptoms and fall height were independent factors of major trauma in all age groups. However, major traumas (17.3%) were related to dumped trauma, fall height and accident site (p<0.05). Conclusion: This study was mainly about head-related injuries, and toddler were most common victims. The relevant factors for the major trauma were falling height for infants, accident site and falling height for toddlers, and accident site, falling height for pre-schoolers.
Keywords
Pediatric falls; Age groups; Prevention;
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1 Available at: http://www.who.int/healthinfo/statistics/ mortality/en/index.html. Accessed on December 1, 2009.
2 Bulut M, Koksal O, Korkmaz A, Turan M, Ozguc H. Childhood falls : Characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score. Emerg Med J 2006;23:540-5.   DOI   ScienceOn
3 Pickett W, Streight S, Simpson K. Injuries experienced by infant children : a population-based epidemiological analysis. Pediatrics 2003;11:365-70.
4 You JY, Lee JI, Ryu JY. A Comparison of characteristics in pediatric trauma patients under 7 years. J Korean Soc Traumatol 2004;17:197-205.
5 Gruskin K, Schutzman S. Head Trauma in Children Younger Than 2 Years. Arch Pediatr Adolesc Med 1999;153:15-20.
6 Housing Health and Safety Rating System operating guidance-Housing Act 2004. Available at http://www. communities.gov.uk/documents/housing/pdf/safetyratingsystem. pdf. Accessed on February 27, 2006.
7 Fiissel D, Pattison G, Howard A. Severity of playground fractures: play equipment versus standing height falls. Injury Prevention 2005;11:337-9.   DOI   ScienceOn
8 Sherker S, Ozanne-Smith J, Rechnitzer G, Grzebieta R. Out on a limb: risk factors for arm fracture in playground equipment falls. Injury Prevention 2005;11:120-4.   DOI   ScienceOn
9 Royal Society for the Prevention of Accidents. Can the home ever be safe: the need to improve safety in the built environment of homes and gardens. 2005.
10 Choi MS, Park JB. Clinical Analysis of Pediatric Falls J Korean Soc Emerg Med 2003;14:555-9.
11 Christine T, Chiaviello, Richard A, et al. Stairwayrelated injuries in children. Pediatrics 1994;94:679-81.
12 Sieben RL, Leavitt JD, French JH. Falls as childhood accidents: An increasing urban risk. Pediatrics 1971;47:886-892.
13 Macgregor DM. Injuries associated with falls from beds. Injury Prevention 2000;6:291-2.   DOI   ScienceOn
14 Hingson R, Howland J. Alcohol as a risk factor for injury or death resulting from accidental falls : A review of the literature. J Stud Alcohol 1987;48:212-9.   DOI
15 Docherty E, Hassan A, Burke D. Things that go bump, bump, bump: an analysis of injuries from falling down stairs in children based at Sheffield Children's Hospital. Emerg Med J 2010;27:207-8.   DOI   ScienceOn
16 Joffe M, Ludwig S. Stairway injuries in children. Pediatrics 1988;82:457-61.
17 Baker SP, O'Neill B, Haddon W Jr, Long WB. The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care : J Trauma 1974;14:187-196.   DOI   ScienceOn
18 Centers for Disease Control and Prevention. Life stage and populations. Available at http://www.cdc.gov/. Accessed on June 21, 2010.
19 Ryu JM, Seo IH, Kim WY, Seo JM, Kim W, Lim KS, A Pilot Study on Environmental Factors Contributing to Childhood Home Slip-Down Injuries. J Korean Soc Traumatol 2009;22:51-6.
20 Khambalia A, Joshi P, Brussoni M, Raina P, Morrongiello B, Macarthur C. Risk factors for unintentional injuries due to falls in children aged 0-6 years: a systematic review. Inj Prev 2006;12:378-81.   DOI   ScienceOn
21 Available at: http://kostat.go.kr. Accessed on August 28, 2009.
22 Committee on Injury and Poison Prevention. Falls From Heights: Windows, Roofs, and Balconies. Pediatrics 2001;107;1188-1191.   DOI   ScienceOn
23 Available at http://www.cdc.go.kr/. Accessed on May 8, 2009.
24 Towner E, Towner J. UNICEF's child injury league table. An analysis of legislation: more mixed messages. Inj Prev. 2002;8:97-100.   DOI   ScienceOn