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Windows 99: a source of suburban pediatric trauma
1Inova Regional Trauma Center, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA.
Insights
Pediatric window falls are increasing in suburban areas, exceeding national averages. Young children under 4 years old are most at risk for severe injuries and fatalities from these falls.
Area of Science:
- Pediatric Trauma
- Injury Epidemiology
- Public Health
Background:
- Window falls are a significant cause of pediatric injuries in urban settings.
- Limited data exists on window fall epidemiology in nonurban environments.
- This study focuses on pediatric window falls in a suburban Level I trauma center.
Purpose of the Study:
- To describe the epidemiology of residential window falls among pediatric patients.
- To identify risk factors and trends in pediatric window fall injuries in a suburban population.
Main Methods:
- Retrospective review of pediatric admissions (ages 0-14) from January 1991 to November 1999.
- Analysis of fall data, specifically focusing on window falls and associated injuries.
- Comparison of injury severity and outcomes based on age groups.
Main Results:
- Falls accounted for 41% of pediatric admissions; 11% were from windows, double the national rate.
- Over 39% of window fall patients required intensive care unit admission; mortality rate was 4%.
- Children aged 0-4 years represented 83% of window fall admissions and all fatalities, with higher head injury risk.
Conclusions:
- Pediatric window falls are increasing in suburban areas, with incidence rates higher than national averages.
- Children under 4 years old are the most vulnerable population for severe injury and death.
- Further national injury prevention research targeting suburban areas is recommended.
Background:
Falls from windows in urban areas cause a significant number of pediatric injuries. Window falls have not been well described in the nonurban setting. We describe the epidemiology of window falls from residential homes among pediatric patients at a suburban Level I trauma center.
Methods:
A review of patients admitted from January 1991 through November 1999 to a center serving a rapidly growing suburban area was performed.
Results:
A total of 2,322 children, ages 0-14 years, were admitted during the study period. Falls comprised 41% of these admissions, and 11% of falls were from windows, greater than twice the national average. More than 39% of children who fell from windows were admitted directly to the intensive care unit. Overall mortality rate was 4%. Ages 0 to 4 years comprised the largest percentage (83%), and all children who died were in this age group. Children < or = 4 years were more likely to have an Abbreviated Injury Score > or = 2 (head injury) than those ages 10 to 14 years (p = 0.032). More than 31% of all children injured in window falls seen at the study institution between 1991 and 1999 were admitted in the last 2 years.
Conclusion:
Pediatric falls from windows in this suburban area appear to be increasing, with an incidence greater than the national average. Children at greatest risk are less than 4 years old. Further research in injury prevention at the national level aimed at suburban areas may be warranted.
