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Severity and outcome of falls in children
A R Adesunkanmi1, S A Oseni, O S Badru
1Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Insights
Falls are a significant cause of childhood injuries, accounting for 25% of all cases. This study highlights common injury patterns and outcomes to inform prevention strategies for pediatric falls.
Area of Science:
- Pediatric Traumatology
- Injury Epidemiology
- Public Health
Background:
- Falls represent a substantial burden on pediatric healthcare systems, necessitating a thorough understanding of their epidemiology.
- Childhood falls are a common cause of injury, with varying patterns and severity depending on environmental and demographic factors.
- Previous research indicates a need for localized data on fall-related injuries in children to guide targeted interventions.
Purpose of the Study:
- To investigate the pattern, severity, and outcomes of childhood injuries resulting from falls.
- To identify common mechanisms and locations of falls in the pediatric population.
- To analyze the types of injuries sustained and their correlation with injury severity scores and treatment outcomes.
Main Methods:
- Retrospective review of 305 pediatric patients treated for fall-related injuries over a 4-year period.
- Data collection included patient demographics, fall circumstances (height, location), injury types, Injury Severity Score (ISS), treatment, and outcomes.
- Statistical analysis was performed to determine frequencies, means, and correlations.
Main Results:
- Falls constituted 25% of all childhood injuries, with a 2:1 male-to-female ratio. Most affected were preschool children (40%).
- Homes (55.3%) and schools (38%) were the most frequent fall locations. Ground-level falls (75%) were more common than falls from height (25%).
- Musculoskeletal injuries, particularly lower limb fractures (48%), and head injuries (6.2%) were most prevalent. Most injuries were trivial (mean ISS=2), with 78% treated as outpatients and a low mortality rate (0.6%).
Conclusions:
- Falls are a major cause of pediatric injuries, with distinct patterns related to age and environment.
- Musculoskeletal and head injuries are common sequelae, but most fall-related injuries in children are manageable with outpatient treatment.
- Understanding these patterns is crucial for developing effective fall prevention strategies in homes and schools.
Abstract:
Three hundred and five patients with falls over a period of 4 years were reviewed with the aim to determine the pattern, severity and outcome of childhood injuries from falls in our environment. The results showed that falls accounted for 25% of all childhood injuries. There were more male than female in ratio 2:1. The age ranges from 5 months-15 years with mean age of 6.15 years + or - 3.63. About 40% of the patients were preschool children. Home was the commonest site of falls in 55.3% followed by school in 38% of the patients. Falls from height accounted for 25% and at the ground level in 75% of the patients. Falls from stairs and storey buildings accounted for 68.3% of falls from height, whereas falls while playing on a ground level occurred in 83% of those whose falls were at ground level. Musculoskeletal injuries with fractures of bones were the commonest injuries sustained followed by head injuries. Fracture of lower limb bones accounted for 48% of all the bone injuries commonest bone being femur. The upper limb bones fractured occurred in 45.6%. There were two cases of skull fracture. Head injuries occurred in 6.2% of the patients and severe in 10% of the head injured patients. Other systemic injuries occurred rarely. Most of the injuries were trivial with Injury Severity Score ranges from 2-26. The mean Injury Severity Score was 2 in 235 patients (77%), 10.5 in 64 (21%), 12.5 in 4 (1.4%) and 21.5 in 2 patients(0.6%). Seventy-eight percent of the cases were treated as outpatient. Hospital stay ranges from 1-45 days with mean of 3.8 days. The hospital stay correlated very well with the Injury Severity Score. Wound Infection occurred in only 1.4% of the patients with mortality in 2 patients (0.6%) with Injury Severity Score of 17 and 26 respectively.