Fall-Related Injuries in Children Aged 0-6 Years: A Trauma Registry Study in Riyadh, Saudi Arabia

Background/Objectives: Falls are a leading cause of injury in early childhood, but detailed trauma registry data from Saudi Arabia remain limited. This study aimed to describe the demographic profile, injury mechanisms, and determinants of severity among trauma registry-enrolled children aged 0-6 years with fall-related injuries treated at a major trauma centre in Riyadh. Methods: A single-centre retrospective cohort study was conducted using the Saudi TraumA Registry at King Saud Medical City, a major tertiary trauma centre in Riyadh. Children aged 0-6 years with fall-related injuries meeting the registry inclusion criteria between 1 August 2017 and 31 December 2022 were included. Demographic, injury and clinical variables were extracted and summarised using descriptive statistics. Univariate logistic regression identified several factors associated with ICU admission and mechanical ventilation; variables significant at p < 0.05 were entered into multivariable logistic regression models to identify independent associations with the primary outcomes. Results: A total of 258 trauma registry-enrolled children aged 0-6 years with fall-related injuries were included (male n = 172, 66.7%; Saudi nationals n = 212, 82.2%). Falls from heights > 1 m were most frequent (n = 153, 59.3%), and the home was the most common setting (n = 157, 60.9%). The most frequent injury types were upper-extremity injuries (n = 114, 42.2%) and head injuries (n = 77, 28.5%). Two-thirds of children underwent an operation (n = 172, 66.7%); 39 were admitted to intensive care (15.1%), and 25 required mechanical ventilation (9.7%). In multivariable analysis, head injury was independently associated with higher odds of ICU admission (adjusted OR 6.4, 95% CI 1.99-20.6; p = 0.002) and mechanical ventilation (adjusted OR 17.6, 95% CI 3.42-91.0; p < 0.001). Female patients had significantly higher adjusted odds of ICU admission (AOR 3.13, 95% CI 1.22-8.04; p = 0.018). Thoracic injury was independently associated with mechanical ventilation (adjusted OR 13.3, 95% CI 1.67-106.7; p = 0.014). In-hospital mortality was 1.2% (n = 3). Conclusions: Among trauma registry-enrolled children with fall-related injuries presenting to a major trauma centre in Riyadh, most had low anatomical injury severity based on ISS; however, a meaningful minority, particularly those with head or thoracic injuries, required operative management or critical care. These findings highlight the importance of injury prevention and early recognition of children at increased risk of severe outcomes following a fall.