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Falls in children birth to 5 years: different mechanisms lead to different injuries
Wendy J Pomerantz1, Michael A Gittelman, Richard Hornung
1Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. wendy.pomerantz@cchmc.org
Insights
More children are hospitalized for furniture falls than stair falls, with increasing trends for furniture-related injuries. Enhanced anticipatory guidance is needed to prevent these common childhood injuries.
Area of Science:
- Pediatric injury prevention
- Epidemiology of childhood falls
- Public health and safety
Background:
- Falls are a leading cause of injury-related hospitalizations in young children.
- While window and stair falls receive attention, furniture falls also contribute significantly to child morbidity.
- This study compares injuries from furniture falls versus stair falls in hospitalized children under five.
Purpose of the Study:
- To compare the incidence of injuries in children hospitalized for falls from furniture versus falls from stairs.
- To analyze the types of injuries sustained in each fall category.
- To identify trends in furniture and stair fall hospitalizations.
Main Methods:
- Retrospective review of hospitalized children (0-4 years) from 1996-2006.
- Data abstraction included demographics, injury details, and costs.
- Statistical analysis (chi-square and t-tests) compared fall groups.
Main Results:
- 318 children hospitalized for furniture falls vs. 171 for stair falls.
- Head injuries and skull fractures were more common in stair falls; arm injuries and humerus fractures were more common in furniture falls.
- Furniture falls increased, while stair falls decreased during the study period.
Conclusions:
- Falls from furniture and stairs are significant causes of pediatric morbidity.
- Hospitalizations for furniture falls exceed those for stair falls.
- Increased anticipatory guidance is recommended for furniture fall prevention.
Background:
Falls are the most common cause of injury-related hospitalization in children younger than 5 years old. Most anticipatory guidance surrounding falls is around falls from windows or stairs; however, falls from furniture also are important causes of morbidity. The purpose of this study was to compare the number of children injured, ages of injured children, and injuries sustained in falls from furniture and falls from stairs in hospitalized children younger than 5 years.
Methods:
All records of individuals from 0 year through 4 years, hospitalized at our institution for a fall from furniture or stairs between January 1, 1996, and December 31, 2006, were retrospectively reviewed. A standard data set was abstracted from each chart. Frequencies were used to characterize the study population. χ and t tests were used to determine differences between groups.
Results:
A total of 171 patients were hospitalized for falls from stairs and 318 for falls from furniture. There were no differences between the groups with regard to age, sex, race, type of insurance, length of stay, Injury Severity Score, or total cost. The most common pieces of furniture from which children fell were beds (33.0%), couches (18.9%), and chairs (17.9%). Children who fell from stairs were significantly more likely to have injuries to their head (64.3% vs. 38.1%); those that fell from furniture were more likely to sustain arm injuries (33.3% vs. 9.9%). There were significantly more skull fractures in those that fell from stairs (39.8% vs. 20.1%) and humerus fractures in those that fell from furniture (30.8% vs. 9.4%) (p < 0.001). Falls from furniture increased during the study period, while falls from stairs fell; the difference was not statistically significant, however.
Conclusion:
Falls from furniture and stairs are important causes of morbidity in children. More children were hospitalized for falls from furniture than from stairs. Falls down stairs are decreasing while falls off furniture are increasing. More anticipatory guidance should be developed and given to families regarding falls from furniture to help prevent these injuries.
Level Of Evidence:
Prognostic/epidemiologic study, level III.
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