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Nonfatal Emergency Department Visits Associated with Fall-Related Fractured Skulls of Infants Aged 0-4 Months
Juliet Haarbauer-Krupa1, Tadesse Haileyesus1, Alexis B Peterson1
1Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Insights
Falls causing skull fractures in infants under 4 months are a significant concern. Caregiver actions like placing and carrying were associated with these injuries, emphasizing the need for safe infant handling education.
Area of Science:
- Pediatric Traumatology
- Public Health Surveillance
- Injury Prevention Science
Background:
- Infants aged 0-4 months are at high risk for fall-related traumatic brain injuries (TBIs).
- Falls are the leading cause of emergency department (ED) visits for TBI in young children (0-4 years).
- Infants under 2 years have a higher likelihood of skull fractures from falls.
Purpose of the Study:
- To investigate caregiver actions and products linked to fall-related fractured skulls in infants (0-4 months).
- To analyze injury data for trends in infant falls and associated factors.
- To inform the development of targeted injury prevention strategies.
Main Methods:
- Analysis of the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) data from 2001-2017.
- Examination of case narratives for infants (0-4 months) with fall-related skull fractures.
- Coding of caregiver actions and product involvement (e.g., flooring, beds, stairs) for fall circumstances.
Main Results:
- Over 27,000 ED visits for nonfatal fall-related skull fractures in infants (0-4 months) were recorded between 2001-2017.
- The majority of injured infants were under 2 months old (46.7%) and male (54.4%).
- Falls predominantly occurred at home (69.9%), often requiring hospitalization (76.4%), with common caregiver actions including placing, dropping, and carrying.
Conclusions:
- Fall-related fractured skulls in infants represent a critical health and developmental issue.
- Comprehensive injury assessments should consider adult actions contributing to falls.
- Prevention efforts should focus on educating caregivers about safe infant carrying and placement techniques.
Background:
Children aged 0-4 years have the highest rate of emergency department (ED) visits for traumatic brain injury (TBI); falls are the leading cause. Infants younger than 2 years are more likely to sustain a fractured skull after a fall.
Objective:
This study examined caregiver actions and products associated with ED visits for fall-related fractured skulls in infants aged 0-4 months.
Methods:
Data were analyzed from the 2001-2017 National Electronic Injury Surveillance System-All Injury Program. Case narratives of infants aged 0-4 months who visited an ED for a fall-related skull fracture were examined to code caregiver actions preceding the fall. Product codes determined fall location and product type involved (e.g., flooring, bed, or stairs). All national estimates were weighted.
Results:
There were more than 27,000 ED visits (weighted estimate) of infants aged 0-4 months for a nonfatal fall-related fractured skull between 2001 and 2017. Most were younger than 2 months (46.7%) and male (54.4%). Falls occurred primarily in the home (69.9%) and required hospitalization (76.4%). Primary caregiver actions coded involved placing (58.6%), dropping (22.7%), and carrying an infant (16.6%). Floor surfaces were the most common product (mentioned in 24.0% of the cases).
Conclusions:
Fall-related fractured skulls are a health and developmental concern for infants, highlighting the importance of a comprehensive assessment at the time of the injury to better understand adult actions. Findings indicated the need to develop prevention messages that include safe carrying and placement of infants.
